By Logan Rutherford
I am fortunate to be part of the American Red Cross Disaster Spiritual Care leadership team, a group of chaplains throughout the country who are trained to respond to natural disasters and mass casualty events.
I’m no stranger to the shrill effects of shock and devastation, which is one reason why I feel I can be effective in disaster situations. For nearly five years, I have worked at the Texas Trauma Institute at Memorial Hermann-TMC in Houston, one of the busiest Level 1 trauma centers in the country, providing spiritual and bereavement counseling to trauma patients and their loved ones.
My first deployment was to Joplin, MO, after the catastrophic 2011 tornado. In 2012, I deployed once again when Hurricane Sandy struck the East Coast. My most recent deployment was in 2013 to the tornado that hit Moore, OK, as a manager for the Disaster Spiritual Care team.
One of my jobs was to provide care to community members as they returned to their properties for the first time after the wind and rain subsided. Nobody knew what they would find, if anything. They were looking for pets, photos – whatever they could salvage. I remember comforting one couple that came back to the ruins of their home to search the rubble for their cat and dog. Miraculously, the cat was retrieved under a large amount of debris, but the relief and joy from his survival was numbed by the loss of their dog. All this family wanted was for another person to hear their story and to bear witness to the pain of their loss. That’s why I continue to deploy to disasters across the country.
However, it’s impossible not to feel overwhelmed by the resilience and generosity displayed by the people in each community. It became clear to me that one of the reasons there were not more casualties was because the community was close-knit and compassionate. One family I met was at home right before the tornado hit. They didn’t own a storm shelter, but their neighbor across the street – who wasn’t home at the time – called and told the family to use his. Just a few minutes later, both of their homes were directly hit.
One boy in Joplin, who had lost everything and was in a shelter, found his prized piggy bank in the rubble. He cracked it open and handed his entire collection to his parents and said, “Mommy, I want to give my money to the Red Cross so they can help another little boy who has lost everything.” Some folks we tried to assist financially took the assistance and turned right around and donated it back so the needs of others could be met.
One of the hardest work assignments at Moore was an event for Plaza Towers Elementary School, where seven children had died in the tornado. I listened to the story of a student who had been saved by his teacher – she shielded him during the tornado to keep him from falling debris. As a thank-you, his family gave the teacher a framed picture of the two of them with messages of gratitude around the border.
But then I met another teacher who had lost multiple children in her classroom. She had just been released from the hospital and could barely walk. She told me about how she had tried to save them but that her arms just weren’t long enough. My heart sank for her. I tried to help her understand that the parents of the deceased children knew the pain she felt and that she had done everything she could. I couldn’t stop thinking about the framed picture that had just been given to her peer, and how I hoped she’d never have to see it. It was one of the most heart-wrenching events I have ever been a part of.
My day-to day experience with trauma survivors and their families has allowed me to understand the physiological effects of trauma, which are numerous. The impact on cognition is very apparent. In Joplin, survivors of the tornado came to seek assistance from multiple agencies in one stop. In order to begin the process, the families needed to complete some preliminary paperwork. I noticed a woman sitting by herself who looked extremely distressed and was just staring at the paperwork in front of her. I approached her and began a gentle conversation. I could tell she was struggling to complete the paperwork and offered to help her, while at the same time acknowledging how difficult simple tasks can be to complete. As we muddled through it together, she was unable to recall simple everyday information such as her phone number and Social Security number.
During many family conversations, I could tell that not a lot of the information and details were sinking in. The “deer in the headlights” look was extremely common. We had to really simplify the information we provided, repeat it, and also provide it in written form. In the hospital, the same approach is necessary. A simple, short document needs to be provided outlining the step-by-step process, and with pertinent phone numbers. We must avoid the temptation to load people up with numerous resources during a time of shock. An overabundance of material will likely just be discarded, or left in a bag somewhere and never referenced.
On some deployments, chaplains worked within Integrated Care Teams to connect and meet with the families who had experienced deaths. Many of the family members were still in a state of shock and dismay. In Joplin, I took the lead in making the initial phone contact with bereaved families, which worked well. Many were very leery on the phone, but identifying myself as a volunteer chaplain with the Red Cross Care Team seemed to lower their level of concern.
Part of our job was to assess and document the family’s financial needs. Some members of the team felt that if they did not give the family the maximum financial assistance available, their meeting was not as successful as it could have been, and the services provided were not enough. This was not accurate. As the chaplain, I continually tried to remind my team that our care is invaluable, no matter what amount of money the client was given. Don’t get me wrong; all of the families we met with received some financial assistance. What we provided too, though, was a deep emotional and spiritual connection with these folks and we joined them in the pain of their journey.
Similar to working in large hospitals, with many moving parts and departments, working within a large structure of disaster response requires effective assessment skills and effective allocation of human resources. Just as in individual pastoral encounters, no disaster is the same. At the core of Disaster Spiritual Care is service to the community, through leveraging and coordinating the existing networks of pastoral-care givers. For instance, in Moore, the First Baptist Church became the major distribution hub of supplies and services. Since this faith community was so well organized, there were already many volunteer chaplains to support their people. It was important that we were seen as partners, and not individuals who were descending on their community to take over.
The presence of board-certified chaplains on major disaster operations is imperative. Spiritual care in these types of events is not simple. It is a dance between direct and indirect care to those affected while working within a complex structure. Having a solid pastoral identity, authority and sound framework enables us to work well with other disciplines. Competent certified chaplains can naturally think on our feet – a necessary trait during a disaster. For instance, in Joplin, we were assured that the death notifications had occurred prior to our contact with any family. This, in fact, was not 100% accurate. One chaplain effectively muddled through a telephone conversation after realizing that a notification had not been made.
Training is available to board-certified chaplains at the NACC conference each year, including the upcoming conference in St. Louis. If you are interested in learning more about supporting the needs of those impacted by disaster and mass casualties, register for the four-hour orientation to Disaster Spiritual Care. I highly recommend getting involved.
Logan Rutherford, BCC, is adult trauma chaplain at the Texas Trauma Institute at Memorial Hermann Hospital in the Texas Medical Center in Houston, TX.