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Edmonton, Alta.

Deborah Kirkpatrick is surrounded by symbols at her ordination, including references to miscarriage, a candle lit at hospital services and ivy to symbolize connectedness in Christ.

The role of the chaplain “serves the important purpose of reminding the system that there is a spiritual dimension to the human experience,” says Deborah Kirkpatrick. “Illness affects our whole being—body, mind and soul. We are continually reminding anyone planning or working in health care that people are not mechanistic beings, that they can not be moved around without effect.

“Our job is to bring a sense of respect, dignity and sacredness to the people. A patient needs to be listened to as a person, not as an illness.”

Kirkpatrick began a hospital chaplaincy ministry 10 years ago. She works at Misercordia Hospital in Edmonton.

“Since restructuring was starting already when I began, I haven’t known anything else.” The stress among staff has continued. “Everything has an articulated cost attached to it and, as a result, there is absolutely no ‘give’ in any program.”

One example of this lack of flexibility shows itself in care to seniors. Each level of care has exact guidelines, so when an individual needs a different level of help, they are immediately moved to that facility. This may reduce some cost, as high level care beds are not occupied any longer than absolutely necessary.

The practice, however, means that patients are often shuffled around, causing instability and stress for them and their families. Nurses also incur a heavier load when the number of patients needing the highest level of care in their units increases, and patient turnover is speeded up.

Depending on the administration in a given facility, chaplaincy programs are at risk of funding cuts. In Alberta, funding for spiritual care does not come from the government, so hospital boards are left with agonizing decisions over where to find money for them.

In 1996, the geriatric rehabilitation program Deborah was working with moved from the Edmonton General Hospital to Glenrose. In May 1997, the 1.4 chaplain positions that had made the move were eliminated. Deborah was out of a job at a time when her salary was the sole income for her and her husband and two small children. Fortunately, a retirement at another facility soon created an opening she was chosen to fill.

Occasionally, eliminating spiritual care programs is rationalized with the argument that community clergy already do the job. This, however, is an inadequate solution, says Deborah.

“Clergy are already busy enough and can not pick up this work in any significant way. There are many people who are not connected to a religious community, and when they are in crisis, they need spiritual care.”
She recounts her experience with a family facing bereavement. The pastor came for a short visit, prayed, and then left. “The dying man’s wife appreciated her pastor’s visit, but turned to me for a hug. She said of her pastor: ‘He’s nice, but he just doesn’t get it.’”

Pastors do not always have the specialized training in dealing with illness, grief, and the working of the hospital system that a chaplain has.

The chaplain also helps build bridges between staff and patients to allow for more personalized care. Nurses do not have time to understand the spiritual/situational needs of each patient. Deborah has been able to help nurses understand these needs. Muslim patients, for example, often wish to have their beds facing Mecca. This is a simple thing that staff may not understand.

When asked about her fears and hopes for the future of health care, Deborah was quick to reply: “I am afraid of everything being motivated by money, especially motivated by profits. Good stewardship is important, but hospitals should not be asking how they can make profit.” Large corporations taking over health care will not want to take on cases that don’t make money.

“For the Christian, caring for the sick is undermined by the making of profit. There are a lot of ethical questions that are coming up out of all this.”

Deborah was ordained by First Mennonite Church on October 20. The road to ordination was postponed by the birth of children, bereavement, illness and job loss. It’s been a long journey for Deborah, her husband Hans Schowalter, and children Elizabeth and Glenna.

First Mennonite has joyfully affirmed Deborah’s call and pledged to support her in ministry. She will continue to offer her gifts and expertise to the church wherever possible.

—Donita Wiebe-Neufeld

When she did request help, their family doctor told them it could take from three months to three years to see a psychiatrist who could help them deal with what was likely schizophrenia. But when Christine expressed thoughts of suicide, they took her to emergency.

That step turned out to be a lifesaver because it got Christine the treatment she needed and it began an educational process for both the Epps and their doctor.

“Schizophrenia is, we found out, extremely common,” Grace says. “One percent of the world’s population suffers from this disorder to some degree. It consumes vast resources in terms of care and hospital beds but receives very little publicity or research funding.”

They discovered that in B.C. there are many resources available, but you need to be a detective to find them. One of the most startling discoveries was that they could have gone directly to a mental health team in their area once they had seen their family doctor.

“There are mental health teams that are funded by the government...that provide medical monitoring by a doctor as well as counselling for the ill person and their family,” Grace says, adding that there is also assistance for those who can’t afford medication.

The Epps found medical professionals to be available and understanding. The psychiatric team at one hospital puts on a nine-evening course for families and caregivers of people with schizophrenia. Grace says it helped them to feel part of Christine’s care team.

There are programs to help teens and adults manage their symptoms. When things have gotten bad, Christine has gone to the hospital where she has felt safe and cared for until she was in control again.

But there have been difficulties.

“At times, hospital treatment can become frustrating as doctors on duty change from one day to the next and procedures which have been put in place one day are rearranged the next—or medications prescribed by one doctor disagree with another,” Grace says. “But the most frustrating thing with the health care system in general is constantly sitting on pins and needles, wondering what’s going to happen to it.”

For example, the emergency room where they first took Christine has been scheduled to close down, but no one knows when. The uncertainty causes general anxiety.

Grace says that the whole experience has strengthened their faith—even Christine’s. Doctors encouraged Christine to keep up her church involvement, recognizing that her belief in a loving and healing God would help her get better. The parents have found the experience to be “an ongoing study,” a journey of reflection and questioning.

“We have rejoiced in healing although there has not been a cure,” says Grace. We are helping [Christine] to learn to ‘hear’ God’s voice without worrying about hearing voices. We have experienced the love and support of a caring church family.”

Through their experience they have heard of other Christians struggling with mental illness and have found themselves working to bring this marginalized group of people back into the church.

“It is ironic that they have often felt more loved and accepted by their secular helpers than by those of us in the church,” Grace says. “Perhaps we need to overcome some of our stereotypes of mentally ill people as being possessed by evil spirits or just being bad people and seeing them for what they are—people who have an illness in their brains. They are sick, but with support they can get better and become contributing members of the body of Christ.”

Grace firmly believes that the church’s role is to minister to the whole person. Through prayer and practical support, the church is able to nourish both body and spirit. In fact, she believes that when ill people feel uncared for, they may actually become sicker, which in turn makes the rest of the body of Christ unwell too.

As for the role of government, Grace is aware that health care is expensive but believes that basic care needs to be available to all people.

“While there is almost certainly room for reduction in some services and perhaps even the transfer of some things to private clinics, I believe a publicly funded system will be best and probably even save money for all in the long run.”

—Angelika Dawson