My first patient for the day—Ruth, a Christian woman in her early 60s—had asked for prayer before surgery, a common request.  When I parted the curtain surrounding Ruth’s gurney in the surgery prep area, I noted a second, older woman seated on the far side of her gurney.  After Ruth and I exchanged greetings, she introduced me to Naomi, her mother.

“I’m having a lumpectomy,” Ruth began, returning her focus my way.  “I’m feeling good about it—they caught it early, and the tumor is small and well contained. They say they should have no trouble getting it all.  But prayer always helps me …”

As usual, I asked Ruth a couple of questions about her faith and what prayer means to her, then I took her hand and offered prayer in language familiar to her, asking for God to bring peace to her heart, to guide the work of her care team, and to provide comfort and healing in the aftermath.

“And God, please also bring peace and comfort to Naomi as she sits in the waiting room.  Sometimes the work of waiting can be even harder, especially when it’s your beloved child who is having surgery …”

Naomi burst into tears and spoke.  “Yes, that’s it exactly.  You see, Ruth is all I have now.  My son died tragically only six months ago.  I just couldn’t bear to lose Ruth, too …”  Ruth turned on her gurney to look over at Naomi, then reached out to take her hand, with seemingly newfound appreciation of her mother’s vulnerability.  I offered my hand to Naomi and she took it, completing the circle.

“Dear God, thank you for your gift of parental love, which endures forever and never gets easier.   You know what it means to watch a grown child suffer.  Please help Naomi to feel your strong presence as she waits while the surgeons do their healing work.  May she draw comfort and strength from knowing of your steadfast love and care—for her, and for Ruth .”

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As adults, we can be remarkably oblivious to our parents’ never-ending concern for our well-being.  We are so determined to demonstrate our ability to manage life without their help that it can be irritating to watch them continue to try.  A few years after I had my own children, I listened as my father expressed concern over a challenge my younger sister was dealing with.  “Dad,” I said with obvious exasperation, “she’s almost 40!  She’ll figure it out.”  He calmly replied, “You’ll understand …” 

In many families, as adult children and their parents continue to age, the balance inevitably shifts, and the children become increasingly concerned with—or actually responsible for—their parents’ well-being.  Members of the “sandwich generation”—caretaking parents while still raising children—can’t help but draw parallels between the two, and it’s easy to forget that the parents were once the responsible ones in the family.  But the parents never forget …

My own children are nearing 40 and have gone through their own crises as adults, and I now understand what my father meant.  Once a parent, always a parent.  As the song from Love You Forever concludes, “as long as I’m living, my baby you’ll be.”  If a child of mine needs surgery at age 60 and I’m still around, I’m damn sure going to worry about it, and I’ll try to be by their side even if they think I’m being ridiculous.  I just can’t imagine ever being released of my concern for my children.  Neither could Naomi. 

The death of a child at any age is among the greatest losses a parent can endure.  The gaping hole in Naomi’s heart created by the death of her son was raw and tender—he will be her baby for as long as she lives.  The thought of losing Ruth as well was simply unbearable.  Ruth was likely also the cornerstone of Naomi’s support network for the final years of her life, bringing additional terrifying implications.  As it turned out, Naomi’s fears prior to this surgery were far more profound than Ruth’s.

Some people believe prayer prompts God to intervene on their behalf, though many do not.  More often, as for Ruth and Naomi, prayer serves as a means of connecting to a power larger than oneself, to the creative force that gave rise to our being and never stops caring for us.  Preparing for surgery that day, Ruth and Naomi were not seeking intercession but accompaniment.  Each, in their own way, wanted to know that their fears were understood and empathized with, that the ultimate loving parent would be holding their hands in their time of need—and that the bond of parental love endures all and is never outgrown, even in death.

“Good afternoon, Richard, my name is Greg,” I say in greeting to the gentleman in Room 901.  “I’m a chaplain here.  I’m making rounds and offering company, conversation, prayer to anyone …”

“HE CAN’T HEAR YOU,” the woman seated at his feet shouts.  “You’ll have to stand closer.”

I walk over to the right side of the bed, lean over gently, and repeat my introduction in a clear, strong voice.

His face lights up with a smile.  “That’s so nice,” he replies.  “I’m a Christian—an Episcopalian—and I love prayer.  I could use some prayer today.”

I glance in the direction of the woman, and he lights up again.  “That’s Elizabeth, my wife.  We’ve been married 72 years.  Can you believe that?”

I rise and cross over to greet her.  She shakes my hand, then pulls me close to speak in a quieter tone. “My hearing’s not so good, either.  What did he just say?”

“He said you have been married 72 years.  That’s wonderful!”

“Well, it’s mostly been wonderful.  We get on each other’s nerves sometimes.  But I suppose that’s true for every couple.”

I agree, and return to my place by Richard’s side.  “What would you like me to pray for today?”

“I just want to go home.  I can’t even remember why I’m still here.”

“You had your hip replaced this morning.”

“I did?”

“Yes, you did.  I overheard your son speaking with the doctor.  It went very well, you just need to rest and heal up a little more before you can go home.”

“Well, OK, that makes sense.  So how about that prayer?  What kind of pastor are you, anyway?”

“I’m a Quaker.”

“A Quaker?  Well, now isn’t that something!  Did you hear that, honey, he’s a Quaker!”

“HE’S A WHAT?”

“I’m a Quaker,” I repeat, speaking directly toward her.

“So give me one of your Quaker prayers, then,” Richard requests with a smile, then closes his eyes.

I speak as loudly as I can muster.  “Dear God, thank you for your faithful servant Richard, and his wife Elizabeth.  Thank you for the way you have blessed them with each other’s love for the past 72 years.  Please fill Richard’s heart with your presence, and grant him the peace and patience he needs to heal.  Bless them and protect them as they journey home, and for all the rest of their days.”

Richard opens his eyes brightly.  “I never heard a prayer like that before.  I like that Quaker prayer!”  He turns toward Elizabeth.  “Honey, wasn’t that a wonderful prayer?”

“I COULDN’T HEAR A WORD HE SAID!” she replies.

◊

While many patient visits are challenging, many others are uncomplicated and joyful, and leave me with a smile on my face and a spring to my step. Experiencing the love of long-term couples, especially when the honey is sharpened with a little vinegar, is one of the best parts of this work—and of life!

The admin assistant for the Spiritual Care team strode briskly into the shared chaplains’ office.  “The ED (Emergency Department) just called.  A man in his 70s died in the ambulance on the way here.  Family has been notified, and it sounds like a bunch are heading this way.  The ED hopes you can get down there by the time they arrive.  That’s all we know.  Oh … and he is a Sikh.”

I began my second internship at the peak of COVID’s Delta surge, and all of the other chaplains were out on the floor.  With trepidation, I grabbed my notebook and headed down the corridor.  As I entered the waiting room I saw a large group huddled in the middle (I later counted eight).  The nurse in their midst looked at me with relief and escorted us back to a large ED room.

The deceased man, Aman, was lying in repose on a gurney.  A few women rushed to his side, weeping; the others stood at a slight distance, looking on.  I, too, stood at a distance, uncertain how to offer support. A man approached me, thanked me for being present, and proceeded to explain the relationship of each person in the room with Aman.  With that, I became one of the family, and soon others welcomed a bit of conversation.

I learned that Aman was a larger-than-life figure in his family and in his first-generation immigrant community, a classic patriarch.  He’d had health challenges for years, but lived each day with such vigor that no one saw his death coming.  I learned another son was on his way to the hospital, but it would be at least an hour before he arrived.  Someone asked, “How long can we stay in here?” and I realized I had no idea.

I stepped out of the room to check at the main desk.  I noticed that the aisles were packed with people on gurneys, all waiting for a room, and I knew I had my answer.  The charge nurse was sympathetic to the situation, and together we concocted a plan to move Aman upstairs to a private chapel where family could remain without time pressure.  “You still have a few minutes before we’ll be ready to move him.”

Back inside, I observed as many ways of responding to the death of a loved one as there were people in the room.  Aman’s daughter, overwhelmed with grief, pleaded to Aman to wake up and refused her aunts’ entreaties to gather herself.  Aman’s son, now thrust into the role of patriarch, sat numbly to the side, then was escorted out of the room by an uncle to find a funeral home that could accommodate the family’s religious practices.  A brother-in-law waxed philosophically that “this passage is a journey we all must take.”  A sister shared, “He was a true salesman—you would come in to buy socks and leave with a suit.”  As she laughed aloud at this memory, her sister scowled and said, “How can you laugh at a time like this?”  In other words, a family like any other …

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There is no preparing for the moment when something unexpected or long feared suddenly, irreversibly, comes true.  There is no way to anticipate how we will respond, nor is there a “right” way to respond.  When tragedy strikes, we find ourselves without a script.  What we need in that moment is the freedom to feel what we feel, and to express those feelings in whatever form they take.  It helps to have an active listener who can offer affirmation, not judgment.  Those who are similarly devastated by the tragedy rarely have the capacity to listen in this way; they are dealing with their own emotions.  This is a situation where a chaplain can be especially helpful.

This particular chaplain, however, was confronting his own long-held fear.  I had just started back into chaplaincy after a one-year hiatus; this was a scenario I had always dreaded might arise, and I had no colleagues to look to for support.  Actually, I realized, I had one.  As I started down the hall toward the ED, I took a deep breath, and a prayer rose from within.  “Dear God, please help me to be who you need me to be in this moment.”

I have come to call this my Chaplain’s Prayer, and I now recite it regularly when I sense that a situation will be challenging.  It helps me remember that the guidance of the Spirit is always available if I can stop overthinking the situation—treating it like a problem I have to solve—and instead create a place of peace in my center from where I can discern what is needed and offer it.  This prayer was a wonderful gift to me that day.

As the family gathered around Aman’s body, I wondered briefly if I should say something, though nothing appropriate came to mind.  I took a breath and received the leading, “This isn’t about you!  Stand back and let them find their own ways to experience this.”  I recalled one of the mantras from my training:  “Trust the one suffering to know what they need.”  And so I did. 

One family member sought me out to reflect on his own mortality.  One found comfort in sharing stories of the deceased.  One shared guilt that she hadn’t gone to Aman’s apartment that morning when he didn’t answer her call, that if she had he might still be alive.  One wanted practical guidance on choosing a funeral home.  Aman’s son, when he returned, just wanted to be held and hugged as he sobbed, finding no such offers among his own family.

As I now understand my Chaplain’s Prayer, what God needed from me in that moment was simply to be available and attentive to each family member, and to offer what they needed as best as I could.  It doesn’t seem like much, yet that day it was more than enough.

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On the morning of my first day of chaplaincy internship, I knocked on the first door of the unit to which I had been assigned.  After a pause, I opened it to find Ann, a woman in her 60s, sitting in bed, staring at a plate of scrambled eggs.  She looked over at me, expressionless, and asked me to come back after she’d had time to eat breakfast.  I agreed and departed, excited that someone actually wanted to talk with me.  When I returned 20 minutes later Ann motioned toward a chair near her bed.  I sat down and she began.

“I’m here because my kidneys are failing.  I’ve been on dialysis for years, but that can go on for only so long.  I’ve been on a transplant waitlist for more than a year, but apparently I’m a difficult match.  One of my nephews turns out to be an excellent match, and he eagerly agreed to donate.  I came in yesterday for workups in preparation for a transplant.

“Just before my breakfast arrived, my doctor came in to tell me that my health has deteriorated to the point that I am no longer considered an acceptable risk for a transplant.  There’s nothing more that can be done beyond helping me to live out my remaining time comfortably.”

“I’m so sorry to hear that,” I replied.  “That’s really difficult news to get.  I’m here for you in any way you would find helpful.”

In a flash Ann was painting vivid images of herself as a little girl growing up on a farm.  Dreams of becoming a veterinarian that evolved into a career as an industrial scientist, breaking glass ceilings along the way.  Dreams of finding true love that never came true, “just a bad marriage that I had the sense to get out of quickly.”  Dreams of having children of her own that were replaced by a bevy of nieces and nephews who adored her (including the aspiring kidney donor).  Close friends who had supported her throughout her illness, and were prepared to support her for the rest of her days.

“You know, as I listen to myself telling you all this, I realize it’s been a great life,” Ann said through tears.  “I’m sad that it’s coming to an end, but I really can’t complain—I have a lot to be grateful for.  Thank you for taking the time to listen.  It’s made today’s bad news easier to bear.”

Before I stepped into Ann’s room, I had grand, if vague, notions of what being a chaplain would feel like.  I had learned many dos and don’ts, and how to chart a visit in the medical record.  I don’t think anything could have prepared me, though, for the reality of sitting in Ann’s chair and hearing her news.  I said to myself, “You said you wanted to be a chaplain.  I don’t know what you were thinking, but it’s ‘Game on’—right now.”

At any rate, Ann was the perfect first patient for me.  Her plight stirred my heart but did not overwhelm me, and it took no effort to draw her out.  She was bright, reflective, and insightful, and she glided easily between happiness, wistfulness, pride, sadness, and gratitude as she told the stories of her life.

Fortunately, the essential elements of chaplaincy are compassionate presence and active listening, and most of us come equipped with at least the basics.  There is more than I ever realized to practicing these well, and either can be hard to do in a given situation, but most of us practice them regularly with family and friends.  I am often surprised when people say, “I could never do what you are doing,” when I have watched those same people do this work beautifully—including with me.

As I closed the door on my way out, I told myself, “OK, I wasn’t so bad.  In fact, it seems I was helpful even if all I did was listen.”  I went back to my office to chart my visit.  I reviewed a list of descriptors of what I had helped the patient explore, and I checked a box marked “Life Review.”  I thought, “That must happen a lot,” and subsequent experience has proved that true.  I looked over other descriptors, such as “loss of loved one” and “patient actively dying,” and thought, “These must all happen a lot.”  Also true, I now know.

“Life can only be understood backwards; but it must be lived forwards.”  Søren Kierkegaard

Ten years ago I retired from a career in consulting and started my blog Midlife Sabbatical with the tag line “Listening for what comes next …”  What came next was a master’s program at the Earlham School of Religion (a Quaker seminary), and I started a second blog, Midlife Seminary, to cover spiritual topics.  After a circuitous journey, life today balances hospital chaplaincy, consulting related to providing health care to marginalized populations, and grandparenting.  Life feels extraordinarily rich, and I feel very blessed.

This is my past decade, understood backwards.  Lived forwards, the Cliff Notes version went like this: 

Quit consulting career in exhaustion.  Get melanoma, get treated.  Start seminary with a vague notion of where it might lead.  Savor classes and life, gradually sensing a calling to chaplaincy.  Put seminary on hold to work for a Medicaid managed care nonprofit.  Leave nonprofit in frustration, stumble into part-time consulting with another nonprofit.  Resume seminary, plunge into a chaplaincy internship with no idea what I am doing.  Become a grandfather, then a caregiver after a post-partum health crisis.  Barely finish internship and seminary as COVID locks down the world.  Resume part-time consulting, begin a second internship, find deep reward in both.  Get prostate cancer, get treated, support spouse through major surgery 25 days after my own.  Crawl together into long-deferred vacation, re-emerge into life as we know it today.  And, yes, that life feels very blessed, too.

As we move through life, we devote increasing amounts of time to understanding backwards—trying to craft a meaningful narrative out of what we have been through.  This is necessary, important work.  But we still have to live life forwards, and it never stops being confusing and unpredictable.  

Chaplaincy has become my learning lab for both of these tasks.  Hospital chaplaincy involves engaging people who are dealing with the limitations of living inside a human body, often facing existential crisis in one form or another. We bear witness to their lives as they seek to make meaning of how they have come to this place, and as they try to decide how to proceed forward.  My engagement with patients is providing me with valuable lessons as I try to do this same work for myself. 

I am launching this blog, Elder Chaplain, to share my experiences and learnings from chaplaincy—and from aging.  Ten years ago I was 57, and even then “midlife” was an aspirational descriptor.  To use that term now, at 67, would simply be denial.  Midlife is over.  More importantly, I don’t want to be in denial about this fascinating stage in life, I want to embrace elder-ness in all its messy glory. 

In many times and places, “elder” has been a status one aspired to, rather than shunned.  Per Wikipedia, “in indigenous North American cultures, Elders are repositories of cultural and philosophical knowledge within their tribal communities, as well as transmitters of this storehouse of information.”  The term is not accidental—one cannot become an elder without also being older, without having lived through many years and experiences, without acquiring more than a few scars.  I’m not sure I yet deserve this honorific, but I feel ready to aspire to it.

“Chaplain,” too, feels aspirational.  Chaplaincy, at its core, is simply offering compassionate presence and active listening to those in suffering.  It is also the most humbling work I have ever done.  One never masters it—each encounter brings unexpected challenges and opportunities for growth.  Chaplaincy has brought me into intimate contact with people whose walk in life has little in common with my own, and has transformed how I engage with people in every part of my life.  “Chaplain” may start out as a job but it quickly becomes an identity, even if it takes years to feel worthy of claiming it for oneself.

I find that these two identities—elder and chaplain—play off each other in remarkable ways.  I inhabit a body that signals its mortality with increasing frequency; my own aging process helps me grow the compassion I need to be present to my patients, and enables me to be a more capable listener.  My patients’ stories, their fears, and their courage put my own challenges in perspective, transforming my experiences of loss into opportunities for gratitude, and helping equip me for my own journey ahead.

Why this blog?  My immersion into chaplaincy has prompted strong reactions from many friends and acquaintances.  Some ask for stories, then say, “You should write about this!”  Others launch, without prompting, into their own stories of hospitalizations or end-of-life experiences of loved ones, often parents.  I am amazed, though hardly surprised, at the hunger many feel for these conversations.  I have that hunger, too—a hunger to share my stories and, especially, to hear those of others.

My intended audience includes anyone seeking to balance hope and acceptance as they encounter loss and mortality—whether with parents, families, friends, or themselves.  I hope to engage anyone who is yearning to hear and share stories that might illuminate the path toward our own mortality.  I want to do so in a way that doesn’t sugar-coat the pain of loss—some of what life deals us is simply devastating.  At the same time, even when it feels impossible, I believe that somewhere there is a light shining in the darkness, and I want to reveal that light whenever it can be found.  If this resonates for you, I welcome your participation in this journey, and I invite your stories as well. 

In living life forward, we are always stumbling in the dark, shuffling our feet tentatively as we look for the next secure step.  The only way I have made it through life thus far is through holding hands with others and shuffling forward together.  Mortality is always messy and difficult, but since it can’t be avoided, I hope to do it in good company.  Please join me!