Chaplaincy and Pastoral Counseling / Healthcare Ministries / hospitality / Pastoral Care

Spiritual Care Week 2019 Part 4: We Were Here First

Each year the COMISS Network promotes Spiritual Care Week. It is an occasion to recognize the different disciplines who offer spiritual care to persons. The theme for 2019 is Cultivating Space. Throughout this week you will hear from CBF endorsed chaplains and pastoral counselors as they focus on this theme. Below is Part 4. Learn more about Spiritual Care Week at

By David Simmons

We were here first.

Simmons, David

David Simmons

That’s what I wanted to say to the new physician who stopped mid-sentence during a medical presentation on rounds when he finally noticed the word “chaplain” on my badge. I could almost see his thoughts: What’s he doing here?

More than a century ago, hospitals were formed by religious institutions to serve the diseased, the destitute, and the dying, Hospitals were not what we think of today. The word “hospital” shares the same root as the word “hospitality,” and the hospital was a house of spiritual hospitality to the most outcast of society. Thus, no person of means dared enter a hospital. Respectable people were treated in the safety and comfort of home.

Medical technology changed that. In the early 20th century, doctors could no longer deliver high tech care in the home. The medical community turned to the infrastructure already in place: the hospital. Physicians were granted “privileges,” and soon hospitals transformed into houses of curative medicine.

But don’t forget. We never left.

Scottish theologian, John Swinton, once asked, “are we doing theology in a medical context? Or are we doing medicine in a theological context?” A crisis of the body is more than a medical crisis. It’s a human crisis. It’s a spiritual crisis. Whether one has great faith, nominal faith, or no faith at all, human beings spend their existence constructing a life of meaning and purpose, built by accomplishments, titles and roles, each of which is fundamentally threatened at the point of diagnosis, disease, or injury.

The professionally trained chaplain opens the door to the world of the spiritual, creating a hospitable place to talk about the questions of body, of mind, and of spirit. Why is this happening to me? What does this mean? Why do I suffer? What happens to me when I die? Where is God in this? What do I do with my regrets? How do I live well? How do I die well?

A medical experience is no longer enough, and the healthcare system knows it. As one nurse leader recently told me, “There are times we’ve done everything we can do for a person. Sometimes we realize we are not what they need. They are isolated. They are afraid. They are lost. And they need something bigger than us.”

Patients are desperate to be seen as something other than patient. Healthcare administrators are doing their best. They are refurbishing rooms, enlarging televisions, enforcing “quiet hours,” and shortening wait times. But they know there’s something deeper that can’t easily be touched. And when they search for help, who do they search for? Do they know we’re here? Are we so integrated into the systems we serve that we are already part of the conversation? Is our care addressing the issues that keep administrators up at night? Are we developing care strategies that touch the highest needs of our organization? And do we even know what they are?

The fact is, the healthcare system is moving to right where we’ve been standing all along. It may be expressed in the words “patient experience,” “whole person care,” or “patient centered care,” but we know what it really is: hospitality.

This is no time keep quiet, to keep our heads down, and visit only those religious patients who will certainly welcome us into the room. This is the time to take a risk. This is the time to claim our place at a table that’s always been ours. This is the time to make ourselves essential members of the interdisciplinary team. This is the time to challenge the plan of care to ensure it aligns with what matters most to the patient. This is the time to name the unmet spiritual needs that are at the heart of the biggest problems in healthcare. This is the time when patients, families, and healthcare leaders need us to function at our highest level. Most importantly, this is the time to remind ourselves:

We were here first.

David Simmons is a CBF-endorsed chaplain serving as the director for the Department of Pastoral Services at Penn State Milton S. Hershey Medical Center in Hershey, Penn. 

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