Pastoral Care by the book

Three times in the past month, I have had to reconsider my notions about pastoral care -- each time, expanding my definition.

Often when I visit someone in a hospital room or convalescent center, I talk and sing hymns and pray. To me, the hymnal is almost as powerful as the Bible at the bedside of someone seeking comfort and only just slightly less powerful than prayer. I remember visiting a man on Easter Sunday who was on hospice care after a paralyzing fall. I had visited him weekly over a month or so, and, on his good days, he always communicated his appreciation with his eyes. This day, I told him I wanted to sing a hymn for him that we had sung in the Easter service that morning, and, something inside me prompted me to tell him that if he wanted to sing along, he could move his lips. I opened a hymnal to the Easter hymn and began singing, and by the time I reached the chorus, he was "singing" along with tears in his eyes but also with a smile in his eyes. Not everyone sings along, but the power of those hymns at the bedside is indescribable. It is certainly a Spirit beyond me that creates these moments of connection and hope beyond hope.

And that is why it has been odd to me to see my understanding of pastoral care expanded recently to include seemingly ordinary tasks.

About a month ago, I was making a second hospital visit to a woman who had just been moved out of ICU, where I saw her on the first visit. After not too long, I opened the hymnal and started singing and she immediately looked distressed. I didn't need any internal promptings to know to stop. She was trying to say something, so I leaned in very close to hear: "can't breathe". I tried to persuade the nurse at the next bed to help, but she told me she wasn't the woman's nurse. I walked to the nurse's station to inform them and they told me to push the call button. I walked back to the woman's bedside and pushed the call button. And then I tried appealing to the nurse at the other bed again. Finally, she called someone on the phone and two people responded, walking into the room without much sense of urgency. That changed when they reached the bedside, looked at the monitors (and maybe even the patient) and concluded that she needed help breathing. I stayed for a moment or two, but things were chaotic, so I decided it would be better to leave and return the next day. I was feeling odd about the visit, odd about leaving, odd about a sense of unfinished business. Then I realized pastoral care that day had simply meant finding someone to help a woman who couldn't breathe.

A week or so later, I made a follow-up phone call to a woman whose husband I had seen in a hospital emergency the day before. The three of us had shared communion and prayer as he waited to learn what doctors planned to do about some very serious hemorraging. (Actually, I took communion on his behalf. When I asked him if he would like that, since he couldn't ingest anything, he readily agreed. "You renewed my baptism yesterday," he said, referring to baptismal renewal in Sunday's service. "You can take communion for me today.") He had had emergency surgery later that day. When I called his wife the next day, she began listing all the things she was trying to do, including reaching his children. But the thing she was most anxious about was the fact that her husband was to report for jury duty the following Monday. Instictively, I took that task off her list. The moment she mentioned it, I could imagine her on hold or navigating the automated phone system designed especially to keep people trying to get out of jury duty from being able to reach a real human. I imagined her trying to do that when she would rather be talking to her children or his or getting back to the hospital or maybe sleeping. And it did take almost an hour, and the phone system was exasperating, but I did reach a real human and get his service postponed. I don't think I ever would have imagined expanding my definition of pastoral care to include a call to the jury commissioner's office. But that day, that's exactly what pastoral care was.

Finally, this week, I was out at coffee with a woman I visit once a month. In fact, she was among the very first people I visited when I volunteered to help with pastoral care on my post-Christmas vacation when I was still employed full time as a journalist. She is living with Alzheimer's disease, and though I did not know her before the disease began stealing her mind, it is clear to me that she was brilliant and witty and compassionate because she still is. We were to have coffee at the Starbuck's next to a Barnes and Noble, but first we went in to the bookstore. I was looking for a particular children's book and my friend went with me, but soon I realized that she was scrutinizing the titles and sections carefully, purposefully. She told me that her husband's birthday was this month. I knew instantly what needed to happen next, because I realized it had likely been years since she had been able to get him a gift. Through a series of questions, I confirmed that she wanted to get him a gift and discovered that there was a particular book she wanted to buy him, a book on personal investing that they had seen together on television. Through another series of questions, we found what she thought was the book. We found a card, too. We had the book gift-wrapped, and we took it to her home, where I left it out on a table. A few days later, her husband left me a message. Apparently the woman, perhaps with help from her caregiver, had hidden the gift until the morning of her husband's birthday. He was calling to tell me how wonderful it was to see the look on her face as she carried the gift to him as a genuine surprise. I never would have imagined pastoral care would occur in a bookstore. But that day it did.

And so, I have come to realize that my definition of pastoral care is inadequate. No matter how I imagine it or practice it, it will always be something else, something more. In fact, I am coming to accept that pastoral care is as big as God.

But what I am most thankful for are those internal nudgings that prompt me instantly to actions I had not anticipated. It is a Spirit beyond me that helps me see so clearly what appears to be needed next. And without that Spirit, I could not do this work.

And I pray that I never do anything to silence that Spirit. And I pray that I always listen not just with my instincts but with my heart.

Thanks be to God for gift wrap at Barnes and Noble.

And thanks be to God for care in its infinite incarnations in all of our lives.