Chaplain Brian Gowan strolls the halls of the Labor and Delivery Department at Houston Methodist Hospital regularly, offering spiritual support for patients and their families. But on this day in January, he was shadowed by Perkins student Charles Kitua as he performed his rounds.
Gowan comforted a woman who tearfully shared she was worried about the ultrasound she was about to undergo. In another room, a couple joyfully introduced their newborn twins to Gowan and Kitua. At the couple’s request, Gowan offered a blessing for the new babies.
Just a few steps away, another chaplain, Chuck Hawkins, visited patients and staff in the ICU, accompanied by Perkins student Uwezo Mwanjala. Hawkins stopped to see an elderly woman in failing health, whom he’d visited a few times before. The patient lay still as her friend sat at her bedside. Hawkins asked if the patient was being moved to hospice; he’d noticed that the status of her chart had just changed.
“No,” the friend said. “She just passed 30 minutes ago.” The friend was waiting for the body to be taken to the funeral home. The chaplain spent a moment with the friend, thanking her for her kindness and faithfulness in accompanying the woman, who had no family, during the last days of her life.
In another part of the hospital, chaplain Martin Chang answered a call requesting spiritual support, along with Perkins student Macy Block. The patient had advanced cancer and had just received some discouraging news. Chang took a moment to chat with the patient and his family and to look at photos of the man’s grandchild. Tears flowed as the chaplain led a prayer asking for peace, strength and healing.
“It was so moving,” Block said later. “I felt God’s presence in that room.”
Equipping Pastors and Chaplains
Those three scenes – of birth and death, of joy, suffering, fear and sadness – are part of the daily fabric of life as a hospital chaplain. And they were part of the experience of Perkins School of Theology students in Health Care/Holy Care, a weeklong January interterm program led by the Rev. Dr. Jeanne Stevenson-Moessner, professor of pastoral care and pastoral theology at Perkins.
The program takes place each year at Houston Methodist Hospital (except in 2021, due to COVID restrictions.) Students enjoy multiple opportunities to shadow working chaplains in the hospital and to hear them discuss their roles and their approaches to care. Eleven Perkins students participated in this year’s Health Care / Holy Care, which took place January 8-13.
“The course aims to equip students with key skills for offering pastoral care ‘in the moment’ for persons in vulnerable situations,” Stevenson-Moessner said. “Some choose to take the course with an eye toward becoming chaplains themselves; others come to prepare for ordained ministry as pastors, knowing that they’ll need to visit church members in hospitals and support them during crises.”
The Health Care / Holy Care program is facilitated through a partnership shepherded by the Rev. Charles R. Millikan, an ordained United Methodist clergy and the hospital’s Vice President for Spiritual Care and Values Integration. Houston Methodist picked up the cost of the students’ hotel rooms and some of their meals during the weeklong program.
“Perkins shares a similar culture and sense of mission as Houston Methodist, which is a faith-based hospital system,” Millikan said. “It is a great training ground for anyone who aspires to go into ministry, and especially for those with an interest in chaplaincy.”
The Night Before
To prepare, students read three books on pastoral care and wrote papers reflecting on what they’d read before the course. In addition, they kept journals during the program and completed another paper at the end of the program.
On Sunday night, the students gathered for the first time for a dinner at the home of the Rev. Stacy L. Auld, system director of spiritual care and values integration at Houston Methodist.
“We take some time to really create a team,” Stevenson-Moessner said.
Each day began with morning worship in the hospital’s chapel, led by a member of the chaplaincy staff. Auld delivered the opening lecture, covering the hospital’s history and explaining how the Department of Spiritual Care and Education operates. The hospital is one of only a few in the nation that remain affiliated with the United Methodist Church but maintains a firm commitment to serve people of all faiths.
“We support patients, families and hospital staff of all faiths and of no faith at all,” she said.
Some patients may identify as atheists and decline to meet with a chaplain; others may profess no religious beliefs yet welcome a listening ear. Proselytizing is never part of the equation.
“I’ve had some of my best visits with people who tried to stop me at the door,” Auld said. “When a patient identifies as an atheist, I’ll say, ‘I respect that. But sometimes you might want a friendly person just to sit with you for a moment.’”
The chaplain’s visit in a hospital room starts with a look at the patient’s chart. Next the chaplain will ask how the patient wishes to be addressed, and what’s most important for the patient that day. Occasionally, chaplains may assist with practical matters, like completing a Do Not Resuscitate (DNR) or other paperwork.
“Often, patients will say things to [the chaplain] that they won’t say to anyone else,” Auld said.
Sometimes, the most valuable form of spiritual care is simply listening. Stevenson-Moessner recalled the story of a family in the initial throes of grief; family members were very emotional, almost hysterical, as they gathered around the deceased. The chaplain stood in the room but said nothing. After family quieted down a bit, he escorted them out of the hospital room and into a family room in the hospital.
“The next day, the chaplain ran into one of the family members who hugged him, thanked him for everything he did, and said the family would not have made it without him,” Stevenson-Moessner said. “He reflected and realized he had never uttered one word as he stood in the corner of the deceased patient’s room. His presence alone was the most important thing in that moment.”
Listening to the Chaplains
Chaplains on the Houston Methodist staff shared with the students how they offer care and support to each patient according to their needs. Patients typically complete a spiritual screening, specifying their religious affiliation, if any, when entering the hospital.
“We don’t necessarily speak to the religious needs of the patient,” Collin Powell said, a chaplain on staff and a Perkins alum. “We speak to their spiritual needs. We are always led by the patient, and what they need. We’re helping patients access their own resources. A patient’s spiritual state can affect healing. We’re serving people as whole beings. People need spiritual care as much as they need physical care.”
Powell added that he spends about half of his time talking to staff members and offering spiritual support to them. Given the stresses in recent years due to the COVID-19 pandemic, burnout is high.
“Doctors and nurses take every loss as a personal affront,” he said. “We saw some rough stuff during COVID.” Nurses often had to comfort patients and hold their hands, as family members were kept out of the COVID units due to concerns about infection.
Some M.Div. students take the Health Care/Holy Care class in anticipation of completing a Healthcare Chaplaincy concentration as part of their M.Div. degree program. In addition to the basic degree requirements, students who enroll in the concentration must complete 12 hours of required courses, including Level 1 Clinical Pastoral Education, Bioethics, plus Health Care / Holy Care, complete six hours (two courses) in core electives and participate in additional training activities. The Health Care/Holy Care course is also counted toward the Pastoral Care Concentration at Perkins.
The Healthcare Chaplaincy concentration is one step toward certification as a professional chaplain, which requires a bachelor’s degree, an M.Div. or equivalent, and a full year in a clinical pastoral education (CPE) residency. Most chaplains are certified by one of two agencies (the Association for Professional Chaplains or the Spiritual Care Association) and endorsed by a denomination (or an equivalent endorsing agency for non-denominational chaplains).
Members of the chaplain staff also talked about self-care. Claudia Stephens, a Perkins student and a CPE resident at Houston Methodist, shared her practice of taking a day to recover after an overnight shift at the hospital. Stevenson-Moessner cited the Biblical story of the Good Samaritan, noting that even the Samaritan accepted help and practiced self-care.
“He didn’t take on the sick man long-term,” she said. “He turned him over to the next caregiver, the innkeeper, and he stayed in the inn for a night. He took a break. Then, he continued his journey after promising to return, check on the injured man, and pay any costs incurred. It was a very responsible act to love and care for the self and the other simultaneously.”
Stevenson-Moessner also described the concept of “physician of the soul,” a term coined by 4th century theologian John Chrysostom. He recognized the wholeness of every person, proposing that spiritual care could help heal “dis-eases of the soul.” Stevenson-Moessner, who is currently finishing a book titled Physician of the Soul, said that chaplains can play a critical role in the healing process.
Top Hospital
By studying at Houston Methodist, students have the chance to observe the daily operations of one of the biggest and best hospitals in the nation as well as one of the most comprehensive chaplaincy programs. Houston Methodist consistently ranks among the top 20 hospitals in the nation, according to U.S. News & World Report. (Currently, it’s ranked 15th.)
Across the Houston Methodist system (which includes the main hospital, seven community hospitals and one long-term care hospital in the greater Houston area), the spiritual care team is made up of 135 employees who represent a wide range of religious traditions, including numerous Protestant denominations, Roman Catholic, Jewish, Hindu, Muslim and others. The staff includes two Perkins grads, Collin Powell (M.Div. ’17) and Russell LaGrone (M.Div. ’17) who took the Health Care / Holy Care course in 2015. Houston Methodist also hosts one of the largest CPE programs in the state of Texas. Three Perkins students are currently residents in the CPE program: Anita Pittenger, Claudia Stephens and Genie Potes. The staff includes chaplains from a range of Christian denominations, as well as nondenominational groups, and chaplains who are Muslim and Jewish. Students toured the hospital’s prayer garden and a Muslim prayer space located in the hospital, financed by a local Muslim group.
Stevenson-Moessner noted that the students, most of them Methodists, were shadowing chaplains from various denominations.
“In hospitals, doctrinal divisions fall away,” she said. “Suffering is the great leveler.”