Susan Catherine Mitchell
Prayer as Presence: Being a healing presence at life's end
It is a Sunday afternoon, and I have just returned from being with the family and friends of a woman who has died in our home hospice program. After an hour of listening to them and mourning with them, I led a prayer service for a dozen people in the bedroom where the body of Maria Rosa lay. I read a poem she had written about the freedom she found in sailing and in solitude; I asked for God's blessing on all her senses, and I prayed that the angels would lead her into paradise. We prayed the Lord's Prayer, and I invited all to come forward and bless her in the way most comfortable to them. I sang "Be Not Afraid" (Bob Dufford) and "Hail Mary, Gentle Woman" (Carey Landry), and some joined in. Her sister was on the phone from Spain, and her elderly neighbors from down the hall were there. Though the hospice nurse needed to leave to respond to another call, the social worker and home health aides remained.
While this service lasted only a few minutes, the hospice team (including my colleague, her principal chaplain) had been present and in prayer of the deepest kind during the last two years of Maria Rosa's life and throughout her dying process. To be fully present to another human being, to listen to her struggles, and to accept her as she is, as Jesus in our midst, is to enter into the prayer of presence.
Since 2000, that is what I have been trying to do to live into my vocation as a chaplain. Many people — especially Catholics — are not sure who a chaplain is and what a chaplain does, especially a lay chaplain. In official church parlance, I am a lay ecclesial minister working in health care ministry. In practice, I am Chaplain Susan. I am board certified (BCC) by the National Association of Catholic Chaplains as part of a varied group of laywomen (37 percent), laymen (13 percent), religious women (30 percent), priests (17 percent), deacons (3 percent), and brothers (1 percent). We work mostly in hospitals, skilled nursing and psychiatric facilities, hospice care, religious communities, and prisons, along with the 6 percent who work in parishes. (For more information on the National Association of Catholic Chaplains, go to www.nacc.org.)
I began my journey where many Catholic laywomen begin: in my own parish. I was the coordinator for junior and senior high religious education at the Shrine of the Most Blessed Sacrament in Washington, D.C. I graduated from the Washington Theological Union, a Roman Catholic seminary for candidates for both lay and ordained ministers, receiving my master's degree in pastoral studies in 2000 and a certificate in spiritual direction in 2010.
In spring 2000, I was present with my father as he died. Until then, I was not sure how I would use my theology degree. The experience of being with him through his last days changed me. I felt drawn to a deeper part of myself, to a more personal ministry.
I completed four semesters of clinical pastoral education at a skilled nursing facility. The focus of CPE is not only to gain skills in interpersonal counseling and prayer but also to discern and grow into one's own call to ministry. Finally, I went through the Catholic church's board certification program for chaplains, which required meeting critical competencies and receiving ecclesiastical endorsement. I met with a board of my peers and was certified in 2002. I am required to participate in continuing education annually and to be recertified every five years.
I am continually learning from those with whom I minister in hospital and hospice settings. My patients have ranged in age from newborns to 100 years old. I am never a finished product. Chaplaincy (and I dare say, any ministry) is about being open to the needs of others, setting aside ego and the desire to "fix" the situation, whatever it is, and being truly present in any given circumstances.
The "prayer of presence" means deliberately opening myself up, both to God and to those I serve. As a chaplain working in a hospice setting, I am part of an interdisciplinary team (IDT) of a nurse, social worker, home health aide, volunteers, and a bereavement coordinator. All hospice providers are required to offer some kind of spiritual support to their patients and families. Some do this by relying on community clergy; most do this by using chaplains. As part of the IDT, I go into patients' homes (including nursing homes) to visit with them and their families. I try to go in with no preconceived notions of what they need. I work with pastors, or deacons, or pastoral associates, if the family wishes. Very often, a patient or the family is not personally connected to a parish or other faith community or does not want to "bother" them.
So how can you, as a parish minister, be a healing presence, particularly at the end of life? Use your own gifts and talents and struggles in the particular way you have been called to serve. Be open to the wide range of needs at the end of life. Some people are very open and voluble, both about their faith or their struggles with God. Others are shy, not wanting to rock the boat or offend; others are so wounded by organized religion that they are not even sure they want anyone connected to a faith community to be there.
I listen to anything. I do not make people stick to ostensibly religious topics. What is most important to a person during his or her life is what is most important during the dying process. Just as we listen to the Scriptures over and over again, so do we need to listen to others tell their own stories. I once listened to a World War II–era army nurse who was at the Battle of the Bulge. She was reliving it during her dying process — she was the one who triaged the living and dead. She needed to tell it to someone again and again, and then finally she was able to accept that her death need not be like that — and that the dead had forgiven her.
I read Scripture, particularly the psalms; I look at the pictures of grandchildren and listen to theories of the Big Bang, or how they fought in Vietnam, or how God has blessed them in their very long lives, and how they yearn to die.
As a chaplain, I see not just Catholics but those of any faith, or those with none. When I became a chaplain, one of the things I found most difficult was to let go of my judgments of how one should practice one's faith, particularly Catholicism. I needed to let go of my own preconceptions of the dying process and jettison my need to be an expert in faith (or in anything, for that matter).
I have made mistakes when I have not listened carefully enough, when I have jumped in with a suggestion that takes the process away from the dying one or the family, or when I have unconsciously favored one idea over another in my mind. In situations where there has been family abuse or neglect or conflict, it is often necessary to separate family members and to minister to each one separately. Jesus came to heal sinners, and we need to be open to the messiness of life and the reality of not ever knowing what the whole story is.
I have always used music in my ministry. You do not have to be a music minister or therapist to connect to people through music, especially those with dementia. You do need to be careful to gauge people's reactions and emotions and to be gentle with them, leaving them in a good place when you depart. I work with another chaplain, Jess Paledofsky, who is also a professional musician and songwriter. He has helped me to see that music is intrinsically spiritual. I will never forget him playing the guitar and harmonica and singing "The Tennessee Waltz" to someone who was homesick. The music gave her a sacred space and allowed her to grieve.
Sometimes well-meaning people try to cheer up others too much or deny the reality of pain, sorrow, and grief. Beware of platitudes such as "When God closes a door, he opens a window," or "I am sure you will feel better tomorrow," or "It is a blessing." These expressions may express the truth, but we often use them to protect ourselves from the grief that is in the atmosphere, to not have to feel the sorrow of others, or to feel that we have helped. Silence can be the most healing of all.
We have to have healthy boundaries when we are with those who are suffering. We need to find a way to be with them, to hold their worries and questions, and then to give them to God. We are not the healers; God is. We can be the conduits, the channels that God uses through our very presence. We can let the person talk about hopes and wishes at the end of life. We can plan memorial services with the readings and music the dying person selects. We can help people word their own prayers. One of the forms of prayer I have found most healing with the sick or the dying are blessings. (See John O'Donohue, To Bless the Space Between Us [Doubleday, 2008]).
For our presence to be healing for others, we need to access our own fears about the end of life and tend to our own relationships with God. For our presence to be truly prayer, we need to offer our own fears and grief to God and let ourselves receive divine healing, love, and mercy. We all need God's healing power in our own lives. When we are open to God moving through us, it heals us. We can let down our own burdens and rest in God's loving embrace, knowing that we too are healed, that God has come to us under our own roof.
While the hospice team ministered to Maria Rosa, she also ministered to us with her openness, her courage, and her willingness to let us into her life. We received God's love through being with her.
The hemorrhaging woman in Mark chapter 5 had the courage and faith to reach out and touch the healing presence of Jesus. May God bless you this day on your journey of faith. May you reach out and receive the healing you need to be a healing presence to others. ML
Susan Catherine Mitchell, MAPS, BCC, is a chaplain with Holy Cross Hospice and Home Care, in Silver Spring, Md., part of the Trinity Health system. She is the author of Through the Valley: The Way of the Cross for the End of Life (Veritas Press, 2009). Comments or questions may be sent to firstname.lastname@example.org.