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Exploring the boundaries of comfort – perspectives from a hospital chaplain by Deborah Wilde

Deacon Deborah Wilde, Chaplain, Oxford University Hospitals NHS Foundation Trust

As a Methodist deacon and whole time chaplain in a large acute teaching trust, an understanding of the value of human life underpins the care that I, my colleague healthcare professionals, our patients and families see each and every day. Daily in healthcare we also confront our own fears, our vulnerability and mortality. Sometimes in ways of denial and distraction that can be very costly.

In a place of academic/scientific esteem (Oxford) do we save life beyond all costs? Does our research centre on compassion rather than advancement in scientific knowledge? Do we really understand what the value of life is at all?

Even among professionals (clergy included) there is confusion and uncertainty about how we die well. And in asking that question, presumably, we make a judgement about how we live well. Woven into this awareness are sociological, ethical, theological, philosophical understandings. Contemporary healthcare chaplaincy works alongside palliative care teams and in hospices trying to discover what it means to have a good death or to die well.

Advancements in palliative care and the development and growth of the hospice movement for adults and children are channelling years of experience, practice and research into learning about good death and good dying. Yet between what we do and the work of ministry in other secular and church contexts, there is a chasm. A chasm created by what is still the final taboo, in which those personally involved with end of life care feel unheard or misunderstood. Here in a prestigious hospital, I am very aware that death is often still, even unconsciously, seen as a failure and not part of the seasons and mystery of life.

The funeral sentence in the Book of Common Prayer reads “in the midst of life we are in death”; our Methodist Service Book has the prayer “Loving God, who brought us to birth, help us to live as those prepared for death”. Recent initiatives involving chaplaincy, palliative care and hospices have challenged public thinking with Dying Matters Awareness Week, the Kicking the Bucket Festival, Death Cafes and so on. What many of us hope for is for a culture that supports, encourages and responds to each stage of life; accepting the value of all in each season.

As a church then, shouldn’t we be luminaries offering an understanding of death in its timely place as a natural part of God’s plan? As a faith-full community we might be helping each other understand and care in a way that is compassionate and sensitive to all. Our understanding of living and dying well needs to be responsive to conceptions of total pain, mental anguish and effective pain control whilst offering a message of hope and redemptive grace.

In recent years we have seen church communities grappling with cultural and social issues that sometimes provoke consternation and disharmony. Boldly we have tried to understand our prejudices, preconceptions and fears about homosexuality and transgender identity, to name but two. Similarly, recognising the extremely emotive elements within these topics, we might create safe space to consider the value of human life, how we live and how we die well. Encouraging healthcare professionals (including chaplains) to speak about palliative care, death, bereavement care and the seasons of life’s journey we then might contradict the sensationalism of the media by honest discovery and learning.

As a chaplain, the support of my local church and circuit is sustaining and incredibly important. Still, sadly, there is often an invisible boundary beyond which it is uncomfortable, costly and difficult for people to go. We need to be a church embracing all of life’s journey and death is (always will be) a natural part of that. The people I journey with on a daily basis, the sick and dying, should never become dislocated or isolated from their community because of our own inability to care or our own distress (and sadly they do). I specialise in paediatric/young people’s chaplaincy and lead a team responding to sudden child death, alongside other areas. Particularly in such cases where illness and death is seen as unjust and undeserved, and the need for reconciliation and guilt is frequently felt, we need to work with (and acknowledge) unsaid presumptions.

In enabling the sick, their carers and healthcare professionals to feel integral to, and held by, the church we might adventure together to explore the boundaries of comfort. For example, what makes some subjects so difficult to talk about? What do we really understand about modern day pain control, and about what happens when we die? What is a good death? What are our deepest fears, for ourselves and others? And then we could pursue the question I face most often when I am with dying people, which is something of “what is my relationship with God about?”. What does faith mean in the face of death?

What becomes evident is that the church needs to have a clear voice that affirms the life-long value of each human story whilst compassionately understanding the complexity and breadth of the journey.