Hospital Chaplains Doctor to the Spirits of Patients, Families

Chaplain John Greenlee stood back from the trauma room at the Thousand Oaks hospital as memories of the deaths he had witnessed suddenly began to file by.

Men of 80 years, children of just a few--all had taken their final breath under the harsh surgical light just paces away.

“I can see them,” the chaplain at Los Robles Regional Medical Center said as if addressing himself, his voice thickening with emotion. “A 17-year-old girl. A woman on her knees praying beside her husband, saying, ‘It can’t be. It can’t be.’ ”

Just as quickly, the ghosts vanished and Greenlee, a tall and cheery spirit, rejoined the living.

“Boy, we’re nearly a full house today, aren’t we?” he said to a crowded waiting room. Eleven people from two families had gathered while loved ones struggled for their lives in the intensive-care unit nearby.

Someone asked Greenlee what exactly it is he does as chaplain.

“I’ve never really known exactly how to explain it,” he quipped. “They say, ‘Pray a lot.’ ”

A ripple of laughter rolled across the room, relieving the ache and the tension.

“This place needs smiles,” Greenlee said in the hallway.

While physicians attend to frailties of the body, Greenlee and a couple of dozen chaplains--salaried and volunteer--attend to injuries of the soul at hospitals throughout Ventura County.

In wide hallways and small waiting rooms, behind emergency curtains and under hanging televisions, they work. They can use a humorous turn of phrase to brighten a fading life, a knack for small talk to quicken the drag of time, a good ear to defuse anger or anguish.

They seek not to win converts, but to ease passage--either back into life or on to death, said Chaplain David Knapp of St. John’s Pleasant Valley Hospital in Camarillo.

The heroism, humanity and pain chaplains witness are typically far removed from the public eye. “The way that people let you into their lives, I feel like I’m walking on sacred ground,” said Chaplain Christine Picchi, director of chaplains at St. John’s Regional Medical Center in Oxnard. “We receive as much as we give.”

Greenlee, 65, who also serves as a minister at Westlake Community Christian Church, said, “You’ve got to love people or you can’t do this thing. . . . Some (patients) won’t let go of your hand.”

Nurses and doctors, the dying, the living, the disbelieving have all sought chaplains’ comfort. Sometimes they even help save lives.

Sunny Kraye, 53, on her third day in the intensive-care waiting room at St. John’s in Camarillo, credited Knapp with helping her 78-year-old mother battle back from a heart attack.

“She told me, she told the nurse, she told David she wanted to die,” the Valencia resident said. “But with David’s help, she was encouraged to fight it. She said, ‘Lying here, I realize how much more I have to live for.’ She’s dramatically improved.”

Traumatized by their injury or illness, some patients, particularly those in their closing years, can make ill-informed decisions about whether to prolong their lives.

“Hopefully, the role I play is to clarify the patient’s wishes,” Knapp said. “And sometimes that means helping, along with the physicians and the nurses, to see if the wishes of the patient are clouded by depression, or by pain.”

He cited the case of another ailing woman who forbade hospital personnel to put her on a ventilator, saying she preferred to die instead.

Knapp helped dissuade her.

“She’s very happy to be alive now,” he said.

“We want to move very carefully and cautiously,” he added. “You don’t want to violate the sacredness of a patient’s wish, but you want to make sure those wishes aren’t clouded by the patient’s temporary mental state.”

Although they are members of health-care teams bent upon the preservation of life, chaplains also must be prepared to allay the guilt of fatally ill patients who are so miserable that they elect to die, Knapp said.

“The job, then, is to let them know when it’s OK,” he said.

Death, paradoxically, is another part of the life process, said Chaplain Donald Ham of Simi Valley Hospital.

After all, Knapp said, “the body is not what is sacred. It’s the sense of beingness, the sense of personhood. . . . Jesus didn’t put all of his focus on his fleshly existence. If that was the most important thing to him, he would have never been able to go to the cross.”

Knapp, 43, a former minor-league baseball player who is an ordained United Methodist minister, darkened when he recalled an incident about two years ago. Bothered by a pain in his leg, a 6-year-old boy was brought by his mother to the hospital for tests.

He had leukemia.

“It was ever so difficult, ever so sad,” said Knapp, who sat with the mother and child while the doctor delivered his diagnosis. “I had nightmares with that child. I had very restless, sleepless nights for a while.”

Faced with such meaningless suffering, chaplains can become victims, too, Greenlee said, their faith sometimes tested.

Ham remembered a trying day in which three lives passed before his eyes.

In the first case, the family of 14-year-old stabbing victim Chad Hubbard agonized in the waiting room at Simi Valley Hospital while Ham served as a liaison between them and the surgical team battling to save the boy’s life.

Periodically, Ham would duck into the swirl of bodies in the emergency room to collect scraps of news--little of it good--that he could deliver to the anxious parents and their pastor.

By the time Chad died, his family had been somewhat prepared, Ham said.

A short time later, a 45-year-old man who suffered a heart attack while exercising died in the same emergency room, his wife nearby.

Then a woman injured in a car accident was wheeled into the same room, where physicians vainly fought to revive her while her husband watched.

“What I try to do as soon as possible is take a break and take a good walk,” said the 62-year-old Ham, soon to be an associate pastor at the Glendale Seventh-day Adventist Church.

But all he could do after this eight-hour odyssey through pain and loss was collapse in bed, drained both emotionally and spiritually.

“In this profession, you must distance yourself appropriately enough from the tragic situations for self-protection of your own psyche and your own well-being,” said Knapp, who uses humor to help insulate himself. “If I (didn’t), then I would be an absolute basket case. Anyone would, whether you were a nurse or a doctor or a radiology technician.”

Picchi, 42, who directs Ventura County’s only chaplain-education program, said: “Hospitals are stressful places for people to work in, because daily they’re being exposed to people who are suffering or have sustained tragedy and loss. And so I think people who work in health care are vulnerable, too. And one of our goals as chaplains is to care for our staff.”

Now in her 10th year as a supervisor at St. John’s, Picchi oversees a staff of seven chaplains at the Oxnard hospital, four of them full-time and all but two of them women. The facility has a hospital chapel, as do the Camarillo, Thousand Oaks and Simi Valley hospitals, with daily services that can be broadcast to patients’ rooms.

Picchi’s mother died when Picchi was a 15-year-old student in Burlingame, south of San Francisco. The event was pivotal in her decision to become a chaplain, she said.

So overwhelming was the support she received from the Sisters of Mercy--who ran her Catholic high school--”that I was very attracted to people who work in the health-care profession and who help others through difficult times of grief and loss,” Picchi said.

In addition to giving sacrament to the dying and funeral assistance to the living, chaplains can float the options of donating organs or tissue, Picchi said.

Consider the case of Michelle Glassman, a Moorpark College student killed in an accident on Sept. 22, 1990.

As many as 65 people across the country gained from her death by receiving transplants of her tissues, bones and organs, said Paul Mathis, who at the time was a chaplain at Simi Valley Hospital.

“Dealing with the family is always the hardest part. But it needs to be done,” said Brenda Perry, a registered nurse at Los Robles who sometimes assists Greenlee and others in inquiring about the harvesting of organs.

Concerned as much with the living as with the dying, Greenlee said he and others never coerce such decisions out of grieving survivors.

“If they say no, you say, ‘That’s fine. We understand,’ ” Perry said in agreement.

Eleanor Roche, director of volunteer services at Los Robles, said Greenlee is particularly experienced with “catastrophic things”--such as the horrors in the emergency room--because he has been a volunteer chaplain with the Ventura County Fire Department for 18 years.

At the yawning door of the trauma room, Greenlee said, “When a patient dies, I encourage people to see their loved ones. There’s a closure then.”

Literally, he added, he sometimes holds the survivors up, to “let them have their last look. Then when it’s time, you tell them. You say, ‘It’s time now.’ ”

Like coroner’s examiners on doorsteps at midnight, chaplains are not always welcome. One elderly patient, seeing Greenlee appear in the doorway of his hospital room, brusquely challenged him: “Is it that bad?”

Greenlee said no.

“I never did care much for preachers,” Greenlee recalled another man saying.

The chaplain shot back in jest: “You know, I never did like them that much, either. They’re usually so stuffy.”

The gruff man appreciated that, so Greenlee asked if he wanted to pray.

“Yes,” the patient grumbled, “but not now.”

While some dispirited patients might lash out at their god or even at the chaplain, Knapp does not take it personally.

“I’m a representative of faith, but I’m not the faith,” he said.

“I’ve found that one of the poorest things I can do is tell a patient, ‘There, there now. You’re not supposed to say that.’ That negates their feelings. It negates their process. It’s better to go with their process and allow it to run its course.

“It’s a lot healthier, faith-wise and recovery-wise, to let the patient get it out.”