By Donald Stikeleather
I looked down at my census and saw the patient’s religious status. Islam. Will I be accepted? Will the person have the patience to see I’m not there to convert him? Will he understand enough English to understand my role? These questions and others go through my mind. Chaplains have an individual pastoral formation and are also expected to be able to provide spiritual resources to all.
I am an APC board-certified chaplain serving newborn and cardiac ICUs of a pediatric hospital in Indianapolis. I also visit adult patients when I serve on-call. I am a white American male, raised United Methodist, now an ordained Buddhist in the lineage of Tibetan Siddha Chögyam Trungpa. I witness suffering and provide compassion, comfort, and reflection. I often pray with Christian patients, having inherited a prayer language passed down from pastors on both sides of the family. I enjoy the diversity of our patients, who travel great distances for specialized care.
My CPE journey included studying at a Catholic hospital, working at busy adult and pediatric trauma centers, and completing an ethics fellowship. I have an M.Div. from Naropa University, a Buddhist-inspired hotbed of contemplative education in Boulder, CO, where I met my spiritual teacher, Reginald Ray.
How does one minister to a patient from another religious tradition? I ask the patient what would be spiritually helpful. When I start there, I get much closer to helping their own spiritual coping meet their emotional experience as a result of medical experience. For example, with Hindu patients, I ask if there is a particular deity that they worship, and if it feels appropriate, I ask permission to pray to that deity. It is always helpful to ask if there is someone in their community to call. It takes a little practice to be a “perfect stranger” in someone else’s religion (click here for a valuable resource). Practice leads to confidence.
How does one minister to a Buddhist patient? There are as many different kinds of Buddhists as there are Christians, and I’m not talking about denominations. For example, there is the Asian Buddhist patient who doesn’t speak English, or speaks English but is actually a Christian convert. There is the American patient who struggles with the idea of leaving Christianity, has read some books, has meditated, but is deep down a practicing Christian. I believe that spirituality is in our very cells, and an intellectual journey may be shorter than the convert’s somatic journey to renegotiate and reconcile long-held beliefs. In cities such as New York, Los Angeles, Seattle, and Boulder, you will find Buddhist communities of converts. There are also householder (non-monastic) Asians who are cultural Buddhists but don’t practice meditation (the monks do the practicing), and there are monks with an extensive support system of followers.
What about the visit? First, I let the patient know that I am aware that she is Buddhist. Having this acknowledged may be disarming. She may or may not want to talk much about feelings. What!? Thoughts and feelings, which lead to stories, are not valued the same way as in other religions, since Buddhism focuses on training the mind. It may help to ask a patient how her mind is doing. This tells her that you understand something about what she values. “How is your heart?” is another good question.
I’m not saying to avoid talk about feelings and thoughts or stories, but wait for the patient to initiate that. “How is this story helpful to you?” “How does your practice work with these feelings?”
Does the patient have a community to contact? It may not be local. I am part of an international community, but am the only one in my city. Does she have a meditation practice? If so, ask if she can do this practice while in the hospital. For some, the hospital is a perfect place to meditate, given the long periods of waiting among the chaotic sounds and interruptions. We meditate not to make the chaos go away (and we don’t need the room to be completely quiet), but to BE with the chaos of life. Some Buddhists do formal prostrations, and while in the hospital, could be encouraged to visualize doing them if they are physically unable. It is important for them to count these prostrations/chants or other practices, so they might need a mala (beaded bracelet), or paper and pen. If they are Christian with Buddhist leanings, they may want to process that journey.
If they have a meditation practice, and you feel comfortable (or not), ask them to teach you the practice (you might already know it) and go ahead and do it with them right there in the room. That helps them know that you are joining them. What you learn, you can teach another patient!
There will probably not be a reason to offer prayer, since prayer is not a Buddhist practice, if you define it as speaking to God, since Buddhists don’t speak of God and eschew the idea of dualism, of human AND Supreme Being.
When I have taught Asian monks about chaplaincy, they have asked eagerly if I chant with patients. I mention this to help you understand that there is a commonality of “this is what I do” when it comes to meeting someone outside of your belief system, with the trepidation of asking yourself to be open to what your patients actually need.
The very first time I prayed with a Christian patient, I felt the patient holding space during this important moment. Thousands of prayers later, I have gained more confidence, knowledge and skill. The same is true of the ministry to patients of other religions I have met. We start to build a reservoir of knowledge and confidence that we can be great spiritual resources. It begins with openness.
Donald Stikeleather, BCC, is a chaplain at Riley Hospital for Children in Indianapolis.
