Monday, July 13, 2009

The Job of a Hospital Chaplain

I fell into hospital chaplaincy quite by accident; it’s not something I ever wanted to do, as a dedicated profession.

My fall took place during my first or second year in the rabbinate. A retired rabbi living in the area volunteered to visit Jewish patients at the local Veterans’ Hospital, but he was going south for the winter, and he asked me to fill in for him.

I learned a lot in this role, because it involved a lot of visiting people I had never met (and who could barely hear me – a lot of them were WWII and Korean War vets), and because it involved the first serious ecumenical work I had ever done.

I learned then, and this idea has been reinforced in the years since, that a hospital chaplain plays many roles, including:

• Officiant – Even though we don’t have last rites (separate from viduy), people consider tehillim a ritual, and benefit from actually seeing the rabbi recite it… even if they personally do not ‘believe in’ prayer.

• Case manager – Patients who don’t have relatives to oversee their cases are often given sub-par care. It’s harsh to say that, but it’s true. A chaplain can ask questions, and even by his presence demonstrate that someone is watching.

• Hope manager – For an aged man or woman who has neither children nor siblings nor friends ambulatory enough to visit, the chaplain represents someone who is interested in his well-being.

• Host for visiting relatives, orienting them to the hospital facility and, as needed, to the community at large.

• Comedian – Well, I had a captive audience. And I didn’t say I was any good at it.

One role I played only rarely was Spiritual Advisor.

I have mentioned elsewhere that the chaplains at that VA felt they were not respected, that the doctors saw them as insignificant and even out-of-place in the hospital. One countermeasure they implemented was a chart (to be stored with the medical chart!) listing dates and times of visits, and key spiritual milestones and benchmarks. Is the patient comfortable with his projected outcome? Is the patient angry, or calm? Have you discussed spiritual issues, life after death, etc?

For me, the idea of imposing this Spiritual Advisor role upon the patient, and especially benchmarking it, seemed foolish then, and it still seems foolish to me today. Perhaps this is different in other religions, but I never saw my visiting-rabbi role as including spiritual exploration. In part that’s because those patients could barely hear me, and were often unconscious. And in part it’s because they were largely people who had not seen fit to study religion or seek out a rabbi beforehand, and it seemed awkward to introduce it for them now. If they sought to discuss religion, I was ready, but I certainly was not going to position myself as Spiritual Advisor, come to investigate their Judaism.

On the other hand, perhaps I was and am too timid. Maybe those patients were just waiting for
me to ask them to put on tefillin. Who can know?

In any case, I never went back to it; I am happy to visit anyone and everyone, but not as an official chaplain.


  1. One of our local hospitals not only has official chaplains but actively encourages their visits, as well as the visits of others from religious-based neighborhood organizations, such as our Bikur Cholim. The assistant supervisor once mentioned to a group of us that "there are no atheists in fox holes, and there are few atheists when faced with imminent mortality." She also mentioned that "God help me!" gets mentioned by terminal patients about as often as "doctor help me!"

    It may not be tefillin that are needed for patients such as these as much as a need for a terminal patient to be assured that there is something better coming, or that he/she is not in a free-fall but has a sure safety net for when the fall comes.

    A rav in the community was called to the bedside of a patient who was ultra terminal but who couldn't seem to let go. When the rabbi came to his bedside he told the rabbi to please talk to him in Yiddish, the language he remembered from his grandparents. The rabbi later told us that he began "Gott is unzer Tate, und ven Ehr reeft intz tzu Eim, darf min nisht nor geyen, ober mir darfen tzu loifen." The man held the rabbi's hand and died, suddenly at peace. When the rabbi was later questioned as to why he would even bother going out in the middle of the night for someone so clearly divorced from Yiddishkeit as this man was, he shook his head and said "There is a "pintele Yid" in every Jew. Even that "pintele" is worth pursuing."

  2. ProfK-
    That story is great; thanks for sharing it.

  3. I certainly read this with my own bias, having been hospitalized upwards of a dozen times (some overnight stays, some weeks' long). Although it is certainly nice to get the Shabbos "bikur cholim" visitors to chat with and pass the time, in my experience there's always room for chizuk when dealing with the frustration of a health condition beyond one's control....perhaps that's "spiritual guidance" enough...

  4. Anonymous 8:28 PM-
    Agreed, and that's basically what I aim to accomplish when I visit people. Anyhting beyond that is gravy.

  5. Gott is unzer Tate, und ven Ehr reeft intz tzu Eim, darf min nisht nor geyen, ober mir darfen tzu loifen.

    Translation, please?

  6. Michael-
    I think it's something like, "Gd is our Father, and when we go to Him, we don't just walk, we run."

    Any yiddish speakers want to correct this?

  7. Trranslation: God is our Father, and when he calls us to him we not only have to go but we have to run. Sorry, should have offered a translation in the comment.