'Where is God?'

[Amelia]

'Where is God?'

Hospital chaplains spread comfort in a crucible of life and death, spirituality and uncertainty

Sunday, April 17, 2005

TOM HALLMAN JR.

The Oregonian

The birth took place after midnight, and the medical complications shocked everyone in the delivery room. The baby stopped breathing for 30 minutes, but doctors, according to a report, had worked frantically and now, at 8:30 in the morning, the child was clinging to life in an intensive-care unit. But the prognosis, Jean Ellen Herzegh told other chaplains, remained grim. The baby probably would die.

The Legacy Emanuel Hospital & Health Center chaplains, gathered for their morning meeting in the hospital chapel, murmured and bowed their heads in prayer while Herzegh, whose turn it was to run the daily session, shuffled through other updates that had been routed to the spiritual-care office.

She read them quickly, trying to get a sense of what the day held for the four chaplains. There had been no major traumas overnight, no shootings or horrific accidents that brought chaplains from home to stay with families in the emergency waiting room. But, as always, little dramas were playing out in Emanuel, a Level 1 trauma hospital in North Portland where the sickest of the sick -- babies, adults and children -- are treated and death can be a daily occurrence.

A baby had died, and the child's parents had asked for help getting ice to cool the body on its trip to a funeral home. Muslim parents in the neonatal unit had asked for a prayer blanket used in their faith. A Buddhist was scheduled to get her biopsy results, and a 27-year-old woman with two young children and no declared religion learned she had cancer.

With medical reports out of way, Herzegh reflected on God, spirituality and uncertainty by relating a story to the other chaplains in which a rabbi -- when events made no sense to him -- found comfort in the belief that all that God does is done well. She finished with a short prayer asking that the chaplains "welcome everything that comes our way today."

Worried family members find their way to the chapel and scribble requests in a prayer book by the entrance. Each morning before they head out into the hospital, the chaplains pray in response to the requests left in the book.

Herzegh opened the book and led the prayer. "We pray for Cynthia and her family, who have discovered cancerous cells in her body. For the man whose cancer radiation is barbecuing his brain. For the baby whose prognosis is guarded. For the family whose two little babies died. For the 15-year-old boy undergoing surgery for a tumor."

She closed the book.

"We pray for the 60 surgeries scheduled in this hospital today," she said. "May all the surgeons, nurses and support staff receive your blessing. May all these prayers -- spoken and unspoken -- pierce the gates of heaven."

Blood, tubes and intensity

There's no institutional church in a hospital. No choirs, no weddings, no Sunday school, no sermons, no members. And yet the chaplains deal with life and death hour after hour, day after day, in an intimate way that gets to the heart of faith. Some days chaplains visit patients in the morning and return in the afternoon to find that they have died.

"A lot of pastors are more like CEOs," said Herzegh as she walked to the adult ICU. "They run an organization and do a great job, but they don't like hospitals. They have an aversion to things that don't make any of us feel good: blood, people with tubes in them, death up close. But being here is an incredible opportunity to engage with people at a time of life that's very trying."

Herzegh, a 63-year-old who graduated from a seminary and was ordained in 1989 by the Presbyterian Church (USA), had helped lead traditional churches in Alaska and Ohio, but hospital work intrigued her. She trained and earned her Association of Professional Chaplains board certification. After stints at hospitals in Texas, Ohio and Idaho, she moved to Emanuel a little more than a year ago, joining a crew of five, including the director.

They are a diverse group -- evangelical, Presbyterian, Nazarene and Lutheran. They must be ordained, must complete 1,600 hours of training, and must finish a residency to learn about hospital culture, medical terms and people of different faiths. All have decades of experience running churches and working in hospitals. They also teach. Emanuel's program, founded in 1951, is one of the country's 10 oldest, and prospective hospital chaplains come there for residencies.

"We treat the families"

On her way to the ICU, Herzegh passed a waiting room filled with men and women. She recognized one woman whose husband had been in the ICU for two weeks following a car accident. The others were strangers, and she'd have to establish a relationship with them when she finished making her ICU rounds with doctors and nurses.

"We treat the families," she said after stopping at the nurses station. "Some families have no faith, some have a lot. We don't preach; we don't convert. We're here to listen. Where is God? That's the major question we get. Where is God?"

Humans, she said, want answers, no more so than when they're in a hospital, oftentimes with a life hanging in the balance. "When we try and figure out why God did or didn't do something, we're going down the wrong path. We're trying to define an answer for an unanswerable question. If you believe in a God who's pulling strings, then you might not be happy with God. How do you explain a 2-year-old who's run over by a car, or a 4-year-old with cancer?"

Herzegh said she tries to help people understand that God didn't cause things to happen. The only meaningful place God can be in a hospital, she believes, is in a place of compassion.

"God never promised us a garden," she said. "Life is a mix of good and not good. Anyone who participates in life is not exempt from that, and you see it in a hospital more than anyplace else. God is suffering with you. The shortest verse in the Bible is 'Jesus wept.' "

The nurse was ready for a briefing about a critically ill patient. Herzegh stepped down from the nurses station to meet her.

"You have to understand," Herzegh said, "I cry, too."

Connecting even with atheists

Fourteen patients filled rooms in the West Wing ICU. Herzegh studied a board that listed them and the doctor caring for them. Some were victims of car accidents. Others of brain injuries or violence. In one room, a doctor shouted at a man and pressed on his chest, trying in vain to get him to respond.

Herzegh was concerned about a man who had been rushed to surgery an hour earlier. He'd been in a car accident and had been in the ICU for two weeks. She stepped into his empty room to talk with his nurse. Two crosses on rosary beads hung from an IV pole. Photographs of the man, his wife and a friend were taped to the doors.

"How's it going?" Herzegh asked the nurse.

"He's sick," the nurse said. "They found he was bleeding internally, and it doesn't look good."

Herzegh had seen the man's wife in the waiting room, and she wanted to know how to approach the woman.

"Is he going to make it?"

The nurse paused.

"He got whisked away to OR," she said. "I believe prayer helps. Even if he doesn't make it, God is with him."

Before leaving the ICU, Herzegh wanted to get information from someone in the operating room.

"I don't take on the burden," she said while waiting for an update. "My job is to open my heart. I don't preach. I can be as effective with an atheist as with someone with deep faith. The point is to listen, to make a human connection."

None of the chaplains carries a Bible. They dress in business clothes. They display no crosses, make no mention of Jesus, forgiveness or sin. Doctors and nurses have but a minute to spare and use it to discuss medical procedures, tests and outcomes. The chaplain can stay for hours and plumb matters of the heart.

"If I sit down with a Bible, it tells people I have an agenda," Herzegh said. "I don't want that. I have to be empty to be with the family. I take my cue from them. I've been told by people that they're not interested. I don't take it personally. I move along."

"God, help the surgeons"

Word returned from the OR that the surgeons were facing an uphill battle. Herzegh nodded and walked to the waiting room. The patient's wife, eyes red with tears, sat in the corner.

"Did he pass?" she cried when Herzegh sat next to her. "Did he pass?"

"No, sweetie. He's still in surgery."

The woman sobbed.

"They called me at work and told me to come right in."

Herzegh took the woman's hand in hers. "You've been admirable with all that is going on, the ups and downs. And now there's another down."

Herzegh explained what was happening in the operating room, telling the woman about the bleeding and how long the surgery was expected to last. The woman fingered a cross hanging from her neck.

"Would you like to pray?" Herzegh asked.

The woman nodded.

"Gracious God, once again we turn to you with such anxiety and fear. God, help the surgeons. It's been two long weeks. Lord, we know you promise to be by her side, to fill her heart. May she trust in you."

The woman hugged Herzegh, who let go of her hand and then walked to the far side of the waiting room to sit with a father whose 17-year-old son had been in a car accident. The boy had massive injuries and in the hours after the accident had gone through 16 units of blood.

"Now," he said, "it is in the Lord's hands."

The father had a Bible on a table next to him, and he told Herzegh he was a man of deep faith. Members from his church, he said, had been by his son's bedside to pray.

"We know the doctors have done all they can," the father said. "Now we must wait."

Herzegh sat patiently while the father talked about his son's birth, life and interests. He explained what the doctors had told him, discussed in details the X-rays and scans he had seen. Herzegh understood the terms in a way that an outsider couldn't. She asked simple questions, allowing the father to reveal what he was feeling.

"Before they took him to the operating room that first day, we told him that our love was with him," the father said. "We didn't know if that would be the last time we would see him alive. I've cried my eyes out. But I feel the Lord's presence in my heart. I see his presence in the practice of the doctors and nurses."

She offered her hand. The man took it, and she prayed.

"You are an inspiration," she said when finished.

She gathered her notebook and returned to the ICU to check on the first patient.

"Is it safe to say that he's stable?" she asked a nurse, still in scrubs.

"Yes."

"OK. I'll go with 'He's doing better.' "

She went to tell his wife the good news.

Days later, Herzegh joined hands with friends and family members who had gathered around the 17-year-old boy's bed. She had been in the ICU for hours, listening and talking. At 1 a.m. she offered a final prayer. The family decided to remove life support.

An hour later, the boy died.

Tom Hallman Jr.: 503-221-8224; []tomhallman@news.oregonian.com[/]