by Meghana Ravi
“The borders between life and death— you know those are so fragile those borders— and a chaplain must be willing to both acknowledge and honor that.”
– Chaplain Rhonda Cooper
My grandmother could blot candles out with her fingers. I’d watch her do it time and time again, fascinated by what seemed like pure magic. Some time when I was 6, I decided that I too wanted to smother a candle with my bare hands. However, when I reached directly for the flame, I burnt my fingers. The burn wasn’t severe—my hand hadn’t lingered long enough near the fire for any serious damage to have been incurred. My skin was, in truth, just a little red and tender, but it hurt.
My 6 year old self thought it was the end of the world. I went around showing everyone my burn and complained incessantly to my mother. Finally fed up, she offered to cast a spell to take my pain away. When I had eagerly passed her my burnt hand, she lightly touched the burned skin and whispered a prayer in Sanskrit under her breath. The pain disappeared immediately. I was amazed. After that, I went to my mother any and every time I got hurt asking her to do the spell. When I asked her to teach me how to do it a few years later, she told me I could only learn it after I became a mother myself.
In my younger years, pain was intimately connected with my family’s spirituality—the mysticism of the prayer, my mother’s own magic. However, as I grew older and began pursuing the sciences as a career, the less mystic pain seemed. Medicine became a science to me, not an art. I didn’t see room for spirituality in what I thought was a completely secular process, a process I hoped to take part in myself one day by becoming a doctor. This was not originally the case. Hospitals are institutes grown out of religion. The first hospital in the world was built in the Medieval Islamic world, where treatment was free and open to all with the generosity of God. Christian monasteries offered sick relief and aid. From its earliest stages, medicine has been intimately linked to religion and spirituality. This is in sharp contrast to its modern day secularism in the Western world. For example, modern physicians have little to no training in how to engage with the spiritual side of patients, even though religion and spiritual beliefs are often important to patients. Due to the general religious pluralism of the Western world, it can be hard for physicians to know of, much less understand various religious credences and the subtle differences between them. Additionally, medical and professional ethics demand that physicians avoid infringing their personal beliefs on patients who are rendered vulnerable by their illness. Finally, scientific theories and discoveries often form the basis for medical treatments and procedure. While scientific and religious beliefs can coexist, they are occasionally in direct conflict with one another (e.g., the Theory of Evolution and the Christian creation myth). Rather than detangle these complications, it is far easier to just separate the two systems altogether. As medicine operates on a mostly scientific basis, it shifted more towards that direction in the split.
One of the first borders patients have to navigate across when they enter the hospital is the border between their own spirituality and the secularism of the medical world that is treating them. Some patients believe in finding meaning in and accepting their suffering while other patients feel abandoned by their faith. While hospitals are equipped to handle illness, they don’t seem optimized for handling spiritual questions—but that’s where the role of the hospital chaplain comes in.
Hospital chaplains serve the spiritual, religious, and emotional needs of both patients and staff at the hospital. They serve all patients, regardless of their religion. Chaplains have some difficult borders to navigate as they help patients. The primary ones they deal with are: one, the borders between different religions or sects of the same religion; two, the border between staff and patient; and three, the border between life and death. To learn more about this role, I interviewed Rhonda Cooper, the primary chaplain of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Hospital. Chaplain Cooper has been serving the needs of the hospital for 14 years (since 2005) and thus has accrued a lot of experience in the art of chaplaincy.
Professional chaplains are trained and hired to be interfaith. They form connections with people of various ages, races, and ethnicities. If patients have more particular religious needs, chaplains make sure they get the resources they need. For example, at the Sidney Kimmel Cancer Center, Chaplain Cooper often encounters patients of Catholic faith. At times, these patients want specific rites or services that can only be performed by a priest. Chaplain Cooper makes sure the priest gets to the patient so their spiritual needs can be met. For Chaplain Cooper, the opportunity to learn about other religions, cultures, and ways of seeing the world has been one of her favorites parts of the job. She routinely performs a “spiritual assessment” on the patients. This assessment includes looking for “what their religion is or isn’t, how important that faith is or isn’t,” and who or what, spiritually, religiously, and emotionally, is their support system. This assessment is useful for medical providers to keep in mind when caring for the patient.
Before meeting Chaplain Cooper, I was under the misguided impression that chaplains only served patients of a particular religion. It was interesting for me to learn how Chaplain Cooper navigates with people of faiths that may be unfamiliar to her. What I learned is that no matter the religion, people often go through similar struggles in regards to their faith, so there are commonalities between patients. Chaplain Cooper is dedicated to having conversations with the patient in broader strokes to allow them to surmount the disconnect they may feel between their medical experience and their religion. She never imposes her own view on the patient, but instead lets them speak for the majority of the time she spends with them. When doing rounds and visiting her patients, Chaplain Cooper follows a firm procedure that mirrors medicine because it is all about “needs assessment, interventions, and outcomes.” Chaplains assess the spirituality of the patient, determine what kind of guidance or conversation they need, and figure out how to get the patient to a point where they are at peace with their faith and themselves.
Another thing I found surprising about chaplaincy was that in a lot of hospitals, chaplains serve not only the patients, but the doctors, nurses, and staff members of the hospital itself. Chaplain Cooper explained that “all hospitals tend to be concerned about staff retention and addressing staff needs so those needs don’t impinge on the work” and so that the caregivers can continue to bring their best to the job everyday. The chaplain provides all sorts of assistance to the staff. This includes “routine support in terms of showing interest in staff [and] what’s going on with them.” To some degree, it includes being there and being aware of their “celebrations” (e.g., a wedding or a baby shower) and “stressors” (e.g., a family crisis or an especially sad death on the unit). In this latter role, Chaplain Cooper sometimes “debriefs” the staff—she holds a moment of prayer that allows the staff to reflect and acknowledge the meaning of the moment or life. Chaplain Cooper emphasizes that the prayer itself is not the central focus—“we’re very pluralistic as you can imagine, very diverse, staff-wise as well as patient and family”—what is key is “the ritual or the pause—taking [a] pause to acknowledge [that] the events happened.” For Chaplain Cooper, this moment is about creating a “sense of hope in the midst of something that’s been very sad”—contextualizing it and searching for its significance amidst the grief and the confusion.
But perhaps the most difficult border chaplains must navigate is the very thin line between life and death. “You become attached to people,” Chaplain Cooper explained. “When someone moves on… or if someone dies, or has a bad illness, even amongst colleagues, it breaks your heart.” There is a constant in and out rhythm to the job. You are “always meeting new people and always saying goodbye to people” at the same time. Chaplain Cooper takes care of her own emotional and spiritual needs by attending church, forming strong connection with people who aren’t connected to her work at the hospital, and spending time at home, which she describes as her “sanctuary.” What she has taken away from her time at Johns Hopkins Hospital is that “life is unpredictable.” While the boundary between life and death is dangerously delicate, many people do go through treatment, enter remission, and get better. They go on to have lives, even if those lives are different than before.
Healing is the art of making whole, as opposed to curing which aims at remedying disease. I believe part of healing is rooted in the spiritual, which can be neglected under the monotonous routine of physical care—an overwhelming array of tests, diagnoses, and suffering. Chaplains emphasize this spirituality; not any particular religion. This is, again, a critical distinction. Spirituality is deeply personal and varies from person to person. Having some spirituality actually improves health outcomes, which suggests that spirituality should be given more emphasis during the healing process for the patient’s benefit. I am of the belief that religion, on the other hand, should not be integrated or overly emphasized in medicine unless it is in the context of spirituality. Imposing religious beliefs on medical systems could potentially have very grave consequences for those who may not share those beliefs. The primary work of chaplains is to heal people, but this goal is sometimes misunderstood or underrecognized, partly because spirituality is not yet a fully integrated part of the curative process even though it needs to be.