The patient was gravely ill. The son and daughter in law huddled outside the doorway, wearing protective gear. The Rev. Jim Shaughnessy, a Jesuit priest and chaplain at Tufts Medical Center, stood with them. They prayed together, and he offered the sacrament of the sick — what many Catholics think of as the last rites — as the patient listened, lying nearby in bed.
Normally, a priest anoints the person who is ill on the forehead and hands. But with the hospital’s current precautions against infection, a hands-on sacrament was impossible. So Shaughnessy blessed the holy oil and placed it on the son’s thumb. Then the couple went into the room.
“I wanted to extend the sacrament through the loving hands of the family,” Shaughnessy said of his action, which felt to him necessary, though unorthodox. “If my prayers can’t reach 6 feet, there’s something wrong. And they can go through glass.”
As the calendar brings Holy Week and Passover together, hospital chaplains in Massachusetts are taking unprecedented steps as they face the coronavirus pandemic. Offering comfort in a crisis that requires physical distancing can be especially hard for clergy who rely on the warmth of hands, eye contact, and the voice to deliver the solace of prayer. Chaplains are feeling vulnerable as they never have before. And they say providing spiritual support for patients, family members, and hospital staff has been both heartbreaking and unexpectedly rewarding in these frightening times.
Chaplains have found themselves adapting and improvising new ways to share messages of hope and healing — and connect with people struggling with pain and loss.
At Massachusetts General Hospital, spiritual care providers have taken a high-tech approach, teaming up to perform multifaith services for hospital staff remotely via Zoom, including Passover Seder and Good Friday services.
At Beth Israel Deaconess Medical Center, a donor provided special catered Seder meals for patients, and the hospital distributed a two-page Haggadah, the Seder text telling the Exodus story.
The multifaith chapel at Brigham and Women’s Hospital, with its stained glass and glowing candles, now has a sign asking that no more than four people enter at any time. Inside, a board is covered with visitors’ sticky notes requesting special prayers. One reads simply: “For all the nurses at BWH.”
At Tufts Medical Center, a Catholic chaplain blessed the emergency department’s doors with holy water, responding to a doctor’s request.
“I think it was really important to gather together and make sure we don’t leave any stone unturned” in facing COVID-19, said Dr. Theresa Gabana, the ER physician who made the request. She said she’s grateful the hospital administration agreed to the move, in which the Rev. Janusz Chmielecki also said a blessing over the staff to keep them safe. “Sometimes you don’t have all the answers as physicians, and sometimes you have to take the extra step and pray,” Gabana said.
Throughout the region, the pandemic has intensified people’s need for spiritual care, hospital chaplains say.
“We’re used to seeing suffering and dying," said Cathy Pimley, supervisor of pastoral care at UMass Memorial Medical Center in Worcester. "Being chaplains, that’s normal for us. This is a whole different level.” Pimley described a fresh urgency in people’s requests for help: “We’re getting more calls for scripture, for rosary beads, for something tangible people can hold onto.”
Coronavirus has put chaplains in unprecedented positions, said the Rev. Katie Rimer, director of spiritual care and education at Beth Israel Deaconess Medical Center. “It’s one thing to go through a crisis, a large-scale disaster,” said Rimer, an Episcopal priest. “It’s a whole other thing when we, the providers, are also vulnerable.”
With the holidays, the challenges are even greater, chaplains say, and the lessons of faith can be more profound.
Shaughnessy, director of pastoral care at Tufts Medical Center, praised the way so many of his colleagues at the hospital have given of themselves. “The story of Holy Week is about Jesus being willing to sacrifice himself out of love,” he said. “Well, I know three thousand people who are sacrificing themselves in this crisis.”
Hospital chaplains say that at its essence, theirs has always been a “ministry of presence.” They hold hands with patients and family members; they sit by bedsides and listen as people express feelings of pain, or fears of the unknown.
Now, concerns about COVID-19 infection mean everything from a consoling touch to a celebratory gathering can be off-limits. While some chaplains still make the rounds inside hospitals, others can’t do so because of their own health issues. So they call patients by phone, or join FaceTime sessions with families.
“I realized that a lot of what I used to depend on was sight,” said Mass. General chaplain Julie Supple. “I would see whether there was family there by the bedside, I would see greeting cards or flowers or other hints that would give me more information about the patient.” With all those things gone, Supple said, “my listening skills have been heightened.”
In many cases, chaplains can’t give the Eucharist to Catholic patients now, even by hand, for safety reasons. “I’ve made a practice of calling people and offering a ‘spiritual communion’ ” by phone, said Supple, a lay ecclesial minister in the Catholic Church.
Providing end-of-life care for coronavirus patients has been tougher than anything else. “That was the hardest visit of my career,” said Rabbi Ben Lanckton of MGH, recalling a recent deathbed experience. He estimates he may have done 200 before, but this time “I had to help a family say goodbye to their loved one with it all happening over the telephone," he said. "A lot of the things I rely on — hand holding and eye contact and physical cues — were out. I don’t think I’ve ever felt two contradictory things as completely, where I felt so needed and so helpless at the same time.”
Amid this crisis, caregivers need spiritual support as much as patients and their families, chaplains say.
“The physicians I know are thinking and planning about the possibility of their own deaths,” said Shaughnessy. “It’s becoming very very real to people. We’re doing OK right now, but it’s very frightening.”
“We’ve been having more and more requests from staff for spiritual support,” said the Rev. Alice Cabotaje, director of spiritual care and education at MGH. So her team is setting up “serenity spaces” for staff around the hospital, and collaborating with the Partners HealthCare employee assistance program and MGH’s social service department to lead virtual staff support groups, said Cabotaje, a minister and Zen teacher.
It was basically “Zoom group therapy,” said Melissa Jocelyn, a nursing director at MGH, of the first such session, which took place Tuesday. “It gave us a space to actually say out loud what we’re feeling,” said Susana Silva, another MGH nurse. “A lot of the feelings that I thought I was feeling by myself, a lot of my co-workers were feeling. I’m not in this alone.”
At some hospitals, chaplains are giving nurses resources to provide spiritual solace to patients themselves — even suggesting words to say.
“They’re asking for help,” explained Beth Israel’s Rimer. “They’re saying, ‘This is a lot. We’re doing our best to care for patients, but we need help. This isn’t our language, this isn’t the role we traditionally play.’ ”
At Mass. General, Cabotaje’s group gave nurses a 28-page package that included scriptural readings for multiple religions, plus end-of-life instructions for COVID-19 patients, including scripts and prayers that nurses can say.
Not being physically present to support hospital staff has been one of the toughest parts of the crisis, said the Rev. Diana Donahue of Mass. General. If you think about hospital ministry, she explained, “the people who go to the hospital are visitors, and the staff are my congregation. They’re the ones I know really well.” So Donahue, a Protestant minister, has been calling nurses by phone. “I tell them I miss them and I love them,” she said.
Chaplains say the crisis has been a remarkable learning experience. “It has taught me a lot about the importance of community,” said Sister Kathleen Gallivan, director of spiritual care services at Brigham and Women’s Hospital and a Roman Catholic sister. “Our motto around here is ‘We’re stronger together,’ and it’s really true.”
“I take some hope from the fact this is the Jewish year 5780,” Lanckton said. “We may never have seen a Passover like this one. But we’ve seen plenty of unprecedented things in our long history. It’s daunting and it’s scary. But the story of our history is rife with moments when the way out was not obvious, and we found a way out.”
Amid the pandemic, many chaplains find themselves turning to bedrock passages of scripture for inspiration.
For Gallivan, it’s the 23rd psalm, which begins “The lord is my shepherd.”
“It’s about being in struggle and getting to the other side,” she said. “We will get on the other side of this. We’re not there yet, but we will.”