This poignant expression is especially true of the sick child but is to some extent true of any serious illness of anyone. The theological perception of the persistence of love in the face of the mystery of human suffering that eclipses for a time hope and faith is not just a jewel to be admired. It is a working principle for the pastor as he or she travels between life and death with fellow mortals, as Richard Baxter said, “as a dying person speaking to dying persons.”
Reimer and Wagner, in this passage and in this book, present the hospital as a powerful arena for genuine spiritual enquiry in the face of the inscrutable mysteries of human suffering. It is an honor for me to be permitted to present their work to you as a reader.
Wayne E. Oates, Ph.D.
Professor of Psychiatry and
Behavioral Sciences
School of Medicine,
University of Louisville
Louisville, Kentucky 40292
July 14, 1984
Acknowledgments
Our first acknowledgment is to each other as co-authors. Reimer is listed before Wagner in the title page out of deference to alphabetical order. We are friends and professional colleagues who have remained so throughout the writing of this book. This is a fully collaborative effort divided as evenly as anything could be divided. Secondly, we thank Charles A. Williams, M.D., who supplied the glossary of medical terms. We deeply appreciate his gift of making the obscure understandable to those of us who must cope with unfamiliar terms in the hospital environment.
We are also grateful to other clergy who have offered the benefits of their experiences in hospital visiting. They represent a broad range of denominations, geographical settings, and ministerial styles. Their stories and insights appear throughout the book. Therefore we thank A. Russell Ayre, Richard Bailar, Donald Bain, Robert Besalski, Richard Dietrich, Sue Gallagher, Rabbi Allan Lehmann, Donald Miller, Richard Sebastian, William Tuck, and John Rutland-Wallis. We thank the following mental health professionals from community and university settings who gave us useful perspectives on community resources and psychiatric hospitalization: Dr. James Archer, Dr. Mary Anna Hovey, and Dr. Douglas Starr. We appreciate the medical advice on technical questions supplied by Robert McCollough, M.D., and David Paulus, M.D.
Wayne Oates read this manuscript and immediately found those places we needed to fill gaps, make the vague specific, and add data. Barbara Beynon did much of the typing, and Ann Terrell managed the difficult task of final typing for two different authors. Stephen Wilburn of Morehouse Barlow had a contagious enthusiasm for this book which gave us just the encouragement we needed. We thank them all.
Finally, we wish to express our deep gratitude to the many patients and parishioners who have enriched this book by sharing themselves with us.
Acknowledgments are appropriate for contributions made to the revision. At Shands Hospital and the University of Florida's College of Medicine, Bill Treloar, Director of Case Mix Management, Loretta Fauerbach, Director of Infection Control, and Ray Moseley, Ph.D., Director of the Medical Humanities Program, made thoughtful and informed suggestions. Russell Clifton, Ph.D., of HCA Grant Center Hospital, and Tom Erney, Ph.D. of the Quest National Center, both reviewed information on adolescence and psychiatric hospitalization. Carolyn O'Boyle typed the revised portion of the manuscript.
Introduction
As Director of Pastoral Care at a major health care referral center, I continue to spend a great deal of time “keeping up” with what is happening in my own hospital. After fourteen years I keep having this fantasy that people will start coming to me to learn what is going on. It never happens. Somehow it goes with my role that I am the one who must initiate and maintain the working relationships.
For parish ministers, the difficulties of hospital visitation and ministry to the physically ill are certainly compounded by the fact that they are “outsiders” to the hospital staff. Unless a minister took clinical pastoral education courses in seminary, it is not likely that s/he had formal training in how to do hospital visitation. Consequently I am impressed that while ministers value pastoral care during the crisis of illness, many find hospital visiting frustrating.
And that is understandable. Physicians, nurses and other staff may appear somewhat unconcerned, if not abrupt with information and/or directions. Even when the pastor has traveled some distance, as is often the case at our hospital, the patient may be in x-ray, having a test run, or be inaccessible for any number of reasons. Even parking is sometimes difficult. All of this is frustrating for the clergyperson, if not intimidating, and adds additional stress to an already busy schedule.
The Hospital Handbook is an effort to provide the divinity student, the beginning pastor, and perhaps the experienced minister seeking a resource for lay visitors with practical guides to hospital ministry. Included are sections which discuss hospital organization, how to gain access to the system, and knowing what behaviors lead to cooperation with staff.
James T. Wagner, Ph.D.
In my first position as a parish minister, it suddenly dawned on me that I did not know where to begin in hospital visitation. I had attended a thoroughly respectable divinity school. I had taken the suggested courses. I knew the finer points of pastoral counseling, medical ethics, and the existential realities of suffering, but I did not know how to find a patient's room. I did not know aneurism from angina.
Fortunately, I began my ministery as an Associate Pastor, and the Senior Pastor was very understanding in showing me around the hospital, introducing me to key personnel, and giving me a good outline of the do's and don't's of hospital visiting. The key to that first learning experience was finding the right information at the right time. I had to learn, and Russ Ayre, the Senior Pastor, gave me clear, practical information.
That was fifteen years ago. The teachable moments have continued. There was the first encounter with a sick child, the dying patient, the need to consult with a physician, the time it was necessary to help a patient get a second medical opinion. There was the move to the community with the university teaching hospital, and the continued need to understand new medical terms. Sometimes the information was easy to get in order to deal with these hospital situations. Sometimes it was not. I wanted a Hospital Handbook to provide practical information for those critical times in pastoral care.
Jim Wagner is the insider at the hospital, the director of pastoral care who is an expert on keeping people like me informed on what is going on in the hospital and how to relate to these developments. I am the outsider, the parish minister who is an expert on reminding the insiders that we need simple, practical assistance in keeping up with our role in patient care.
Lawrence D. Reimer
INTRODUCTION TO THE REVISED EDITION:
We are grateful for the opportunity to do a revised edition. In the four years since the Handbook was published, we have maintained a careful file of suggestions from users and reviewers, as well as new material which we believed would strengthen the book. The growing number of readers deserves the best we can offer and Morehouse-Barlow agreed.
One dimension of the revision is to update some of the rapid changes occurring in the health care field. Most of these are reflected in Chapter One, sometimes accomplished by changing a verb from future to present or past tense. The issue identified at the end of this chapter, making health care available to all persons, remains a central focus of debate in America.
New material is to be found in several places. Chapter Four has been expanded