I wish u knew…the role of the chaplain in cancer care

Tim Hampshire

Paul is a 30-year-old schoolteacher with leukemia. His cell count is dangerously low. Most of his time these days is spent lying on his back hooked up to an IV. He draws shapes on the ceiling with his eyes until he falls asleep. When he wakes up, he continues.

The doctors and nurses have all been excellent with him. He has no complaints about the medical attention he’s been receiving.

Today, he has taken a break from drawing shapes so he can think about the things he wishes he hadn’t done. It is a harsh exercise to see three decades coming out of the corners, the cracks in the floor, everywhere.

There is a light knock at the door. He turns his head listlessly, eyes half-open, to see who it is.

Poking her head around the door frame is a smallish woman. She has short grey hair, a rosy face, and her eyes are kind. The corners of her mouth are turned down, but she is smiling.

“I’m a member of your team; I’m a spiritual care provider. I’m an encourager, but I’m also a listener, and whatever you’re feeling, I want to join in with that,” she says.

“Come on in,” says Paul.

The woman’s name is Kava. She is the Staff Oncology Chaplain, Palliative Care Chaplain, and Bone Marrow Transplant Chaplain. If you have cancer, are dying, or are giving or receiving bone marrow, she will hear you out. That’s what she does; she listens to people.

Her goal with Paul is to find out “what his journey is, what he is discovering.” It could be that Paul is entirely without religious faith. In that case, she will simply talk to him so he can know that someone cares about his well-being. It might be that Paul is a staunch Christian. In that case, she’ll talk to him about God. If he wants his community priest to come absolve him of his sins before he dies, she’ll arrange it. Paul might also be a Buddhist or a Muslim. That’s fine. Kava tries to listen with “”A certain agnosticism…I just want to marvel at what they are able to do.”

That sense of wonder is the main tool of her trade. She sees people when their lives are in shambles. The physical suffering that accompanies most cancer treatment feels punitive. Most people, who see themselves as more or less good, jump right to the question, “why is this happening to me?”

“I don’t know why it’s happening to you,” Kava will say in a voice that is low and reverent. She has a way of making patients feel respected. Perhaps they only need to see that there’s another human as distraught as they are. A community of the distraught is still a community, and a being in a community is better than being alone in a hospital bed drawing shapes on the ceiling.

But she doesn’t just shrug her shoulders as the patient rages and rages against the dying of the light (she likes to quote Dylan Thomas, the Book of Pslams, and anything else that codifies what it is to lament.) That wouldn’t make her a very good spiritual care provider. Instead, she likes to stick it out and keep asking questions. And keep listening. That way, “the listening will shift something for someone. The load might get a little lighter.”

Often, the listening works. She has seen people with no religious faith find some at the depths of their despair. She has seen people with strong religious faith drop it and go on feeling liberated. She has seen people with some religious faith have transformative experiences and begin a new phase of their lives. Every subject inspires her awe. And that’s how she goes on.

Not everybody has such an easy time with going on. “This is a deep strain in oncology,” she told me. “People really feel like they can’t go on.”

That’s something like what Paul is feeling. His sins were with him in the room before Kava walked in. They are installed in his heart. He can still feel them. Now he thinks the leukemia might be here to take him and his sins away. And he’s afraid, though he feels he might deserve it. That’s what he tells Kava.

She doesn’t take a firm standpoint on most issues of spirituality, but when she sees someone trying to make their cancer a price for their past decisions, she steps in.

“You can say: God, please take this from me. And I believe God does…but people don’t feel that forgiveness because they haven’t forgiven themselves.”

She doesn’t have the authority to formally absolve Paul. But she can offer him the chance to go on comfortably. That’s what she’ll do. She will hear his whole journey, no matter how he tells it, and accept it on face value. No matter what he tells her, she will make him feel that he is whole and permissible and worthy. And she’ll come back and do it all again. Being a chaplain is not a one-visit job. “A spiritual care provider needs to be able to stay long enough to hear the lament before they get the person to try to be hopeful,” she told me.

She will leave Paul’s room to visit anyone else who might be suffering. And Paul will draw the shape of a cross on the ceiling, then on his chest.

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