My name is Sally Trethewey, and I’ve been the Presbyterian Chaplain at the Cancer and Haematology Ward at the Royal Hobart Hospital since 2019. This is a strategic ward for pastoral care as cancer diagnoses naturally lead to distress and fear for patients. Particularly in this COVID era, visits are limited, so listening and understanding a patient’s life and health stories and responding with God’s love, empathy and compassion is a privilege.

There are many joys and heartbreaks in hospital chaplaincy, but joys outweigh heartbreaks.

Hospital Chaplaincy’s Joys

A joyful time for chaplains involves observing patients’ morale change in hearing their story. Patients are often quiet, reflective, sad, fearful and/or distressed. Serious illness can mean contemplating meaning and purpose in their lives. Reflecting their thoughts and emotions (paraphrasing) can shift their mood from disinterested politeness to greater engagement to smiling and laughing. At this time, I try to discern whether they have any spiritual beliefs, helping them with their health journey.

Christian chaplains believe everyone is made in God’s image, for relationship with Him and with others (Gen. 1:26-27). [ST1] Yet, suffering patients can feel lonely, even among loved ones. Gently sharing the truth that a patient is never alone, because God is always present can be a great encouragement (Matt 28:18-20).

Some patients receive a positive outcome (remission) which is a joy. They are buoyed to return to “normal” life, engendering hope their life will continue. Chaplains celebrate this joy with them. My parting comment as they leave hospital is “I hope I don’t see you again”!

Surprisingly, many patients, despite their worldview, agree to prayer. Their hospital stay helps them more readily accept their mortality in humility and they begin asking life’s big questions. Sadly, younger patients are often growing up with a worldview which never considered spirituality. Indeed, this can be a blessed time to discuss it, as they don’t carry negative baggage from 20th century Christianity.

It’s a joy/privilege to work amongst competent and passionate clinical staff, with their own worldviews. After some years, we know each other well and chaplaincy stereotypes are being broken. Particularly during my first year in the Cancer Ward, I made some glaring errors, readily pointed out by nurses and patients. After sincere apologies and willingness to learn/change were well received, they started to trust me. Both staff and patients need to know Jesus (John 3:16).

I am greatly encouraged to see God working in many hospital “coincidences”, for example, meeting people I’ve known or who are friends of friends (Tassie is a small community!). God can uses all encounters in His plans and purposes.

It is always a mixed blessing meeting committed Christian patients. With cancer, they lean heavily on God, His Word and their hope of eternal life. Several patients have been blessed witnesses in accepting it’s time to “go home” in palliation. Staff noticed their faithful witness. 

Finally, public hospital ministry means the joy of meeting a plethora of patients from different ethnicities, languages, ages and demographics, hearing their amazingly diverse life/health stories.

Hospital Chaplaincy Heartbreaks

It’s heartbreaking to hear a long-term patient’s illness is terminal. Chaplains walk sensitively with dying patients and their families through palliation, hearing of impending griefs and losses – something Job’s friends should have done (Job 2:13). An additional heartbreak is when a patient’s illness takes hold and they die quickly (Acts 17:26).

Suffering patients become more anxious when dealing with fractured family relationships. I’ve witnessed distressing family arguments in hospital rooms and try to navigate this angst with them (Jeremiah 17:9).

At times, we minister to patients with a lifetime of tragedy. This includes severe disabilities, life in orphanages or foster care, sexual and/or emotional abuse, ubiquitous pain, homelessness, financial destitution, stroke or heart attack, being without loving care or support ending in terminal cancer. Talking about God’s love can sound disingenuous and existentially meaningless (c.f. Ecclesiastes 9:5-6) and needs much godly wisdom.

Without blame or judgment (Psalm 9:8; Romans 2:1), chaplains hear patients get angry, wallow in denial and become defensive. Some have difficulty discussing their health, even with doctors. Others ignore symptoms, taking continual risks with their health (smoking, excessive drinking, drugs, obesity, anorexia, bulimia, speeding cars and motorbikes leading to serious accidents). Some patients blame everyone else including clinicians, staff, loved ones and chaplains!

Systemic sin in hospitals is also heartbreaking. Issues like staff disunity, gossip or inappropriate patient/staff actions are discouraging. It’s most disappointing when other Christians do this, as their actions bring the gospel into disrepute. Systemic failures affecting patient care are also difficult. For example, mental health patients labelled and not believed, then misdiagnosed. Public hospitals are always underfunded and understaffed.

Sadly, many Presbyterian patients in public hospitals are nominal Christians. They were brought up as Presbyterian by believing 20th century parents and grandparents and many attended Sunday School. As they’ve aged, they no longer believe in God or attend church. They don’t bring up their children to love and fear the Lord (Ps 34:11). It’s a privilege to visit and encourage them to re-engage with their faith.

The joys and heartbreaks of hospital chaplaincy are always there, but this ministry remains a privileged ministry every day. Hospital chaplaincy is certainly a specific, but important calling for those with robust faith in God’s truth to minister in such a sad, sinful and messy world.

                                                                                                – Sally Trethewey