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Although it is 6:00 a.m. and still dark, the parking lot of the hospital is already filling up. In an hour only the far lots will be available. People are filing from their cars and meeting up with others who are getting off buses. They are all moving toward the hospital, its many windows spilling light into the last darkness before the day.
Who are these people?
Some are patients on a fourteen-hour fast hoping to be first in line for blood testing, or patients coming for day surgery, knowing they will sleep in their own beds tonight. Some are family and friends of patients—a wife who left the hospital late last night is now returning, a son who visits his father in intensive care every morning before he goes to work, a clergy person notified an hour ago that a parishioner had been admitted last night. Others are medical and non-medical caregivers—nurses on the day shift, doctors who need to fill in charts and visit patients before the rush begins, people who work in the cafeteria, maintenance personnel. This is just the beginning. Throughout the day there will be a flow of patients and staff in and out of the hospital and the adjacent medical center. Each has an assigned role—patient, visitor, nurse, doctor, engineer, lab technician, human resource manager—these roles determine expectations and relationships. Some of the rules governing these roles are written down, in statements of patients' rights, doctors' responsibilities, and job descriptions for everyone from volunteer to CEO. There are also unwritten rules—assumptions about how things are done, tacit agreements about what is appropriate, psychological blocks put in place by previous hospital experience. These unwritten rules often determine inner attitudes and outer behavior.
Welcoming Spiritualities
To deepen the scenario, suppose these people are trudging into a hospital and medical center within a faith-based healthcare system. This extra dimension of the carefully structured social interactions of healthcare delivery is expressed in a number of ways. There is a theological context to the ethical positions on medical, organizational, and business issues. The hospital has a multifaith Pastoral Care department that has recently been renamed Spiritual Services. Also there are close working relationships, even partnerships, with local churches, synagogues, and mosques. Recently, this faith-based system has gone on record as welcoming and encouraging the spiritualities of all people, both patients and employees. This includes spiritualities grounded in its own tradition, those indebted to other faith traditions, and even those outside organized religion. A faith-based healthcare system may welcome these spiritualities because it is responding to data from medical research, or because it is committed to holistic care, or because it is simply attentive to what patients want. It may also be that faith-based organizations have a distinctive take on what goes on in the midst of the socially structured delivery of healthcare. As they are faith-based, they struggle to be sensitive to the personal spiritual dynamics that inform, sustain, and go beyond the usual roles. These spiritual dynamics are always present, but they are not always attended to. They are subtle but real, and they promote qualities people crave in their care such as respect, compassion, listening, and peacefulness. When people are in tune with the spiritual depth hidden in the hubbub of healthcare delivery, a fuller humanity is present. Faith-based organizations acknowledge this reality and therefore welcome spiritualities because spiritualities—beliefs, stories, and practices—are the means by which we attend to this present yet elusive spiritual reality.
Beliefs, Stories, and Practices
Spiritualities are composed of beliefs, stories, and practices that focus on the spiritual dimension and its subtle interactions with the physical, psychological, and social. These beliefs, stories, and practices are not an end in themselves. They are in the service of spiritual consciousness and are meant to bring awareness into the soul space, the deepest center of consciousness. Spiritualities are created for the express purpose of staying in touch with the spiritual. To welcome spirituality is to cultivate the spiritual consciousness of people in the midst of the multiple social interactions of healthcare. Spiritualities are, of course, irreducibly individual. A person may belong to a Catholic, Hindu, or Islamic community, yet this alone cannot predict their spirituality. Most have probably selected one or two beliefs from these traditions, have a particular sacred story that they prize, and engage in one or another religious practice. These particular beliefs, stories, and practices may not be the ones the officials of the tradition consider central. Also, spiritual people have gathered beliefs, stories, and practices from their individual experiences and blended these with what they have learned from their religious traditions. In fact, collective traditions and personal experience are the two sources that people draw on for the beliefs, stories, and practices that comprise their spiritualities. The result is a unique combination of influences that structure consciousness in a particular way. The only way to discover a person's spirituality and the effect it is having on their consciousness is to listen carefully as they reveal it.
Consider a patient who believes God is present no matter how bad things get. He connects this with a song he always sang in church, "My God, is a rock in a weary land/in a weary land/in a weary land/My God, is a rock in a weary land/ shelter in a time of storm." His grandmother also told him stories about the Depression when they had nothing but faith to keep them going and they prayed every morning for strength. Likewise, he prays every morning, "Lord, give me the strength to get through the day."
Consider the nurse who believes that because everybody is related to God and God is behind all that exists, everybody is related to everybody else. She once had a dream that reinforced this belief in which her sister, who lived two thousand miles away, was sick. In the morning she called and found out her sister was in the hospital with pneumonia. The nurse felt connected to her sister in a way that was not completely conscious. She concluded, in what she herself admits was a wild leap, that there is an invisible network of communication throughout the universe. She used that network to pray for her sister. Now she prays for all her patients. She does not pray for specific things, like better health or that more people would come and visit. She prays for them, that they find what they need and want.
Consider the upper management executive who believes that, down deep, people want to help other people. She remembers how she found this out about herself, when her boss turned to her and said half-jokingly and half-seriously, "Face it, Joan, you're a do-gooder." Once she faced it, she was happier. Now, Joan often begins department meetings with "Let's see what we can do to make things better for people." Colleagues are not sure whether to take her seriously. She often supports the staff by reminding them that what they do affects other people, even though they do not immediately see it. Although she says she is not very religious, she considers this her spiritual practice—reminding herself and others that down deep they are driven by a desire to help.
The question to ask about these three cases is how does this spirituality, this combination of belief, story, and practice, shape their consciousness, open them to the spiritual dimensions of human interactions? Spiritualities are the stethoscopes people use to hear the pulse of the spiritual in every situation. The more people explore spiritual beliefs, tell and retell spiritual stories, and engage in spiritual practices, the more developed their spiritual consciousness becomes. In the language of one spiritual tradition, they develop eyes to see and ears to hear. What they see and hear is the spiritual, not as a "thing apart," but a deeper activity that arises and transforms the social interactions of healthcare.
Now, what does this spiritual activity look like?
A Story of Receiving Spirit
The spiritual dimension of life is characterized by a flow of receiving and giving spirit. Spiritually developed people are open to receiving spirit whenever and from whomever it is offered. Here is the story of a speech therapist who is unexpectedly offered a gift of spirit:
- You walk the halls of this place, and what do you see from room to room? Most people peer in and see this retarded child or that one. They focus on this particular mannerism or that deformity. I do it too. It's very compelling, that picture.
- But one kid flipped me around on that. We were doing language exercises. And for some godforsaken reason I'd chosen the exchange "How are you?"…"I'm doing fine." We'd go back and forth. Well, he was having quite a hard time of it, slurring out. "Iy dluee fie" or some such. "Let's try again, really slowly," I said. "How…are…you?" And he slurred, "Iy dluee fie." Then he suddenly burst into this wonderful crazy slurry laugh. It was the nuttiest sound we'd ever heard, either of us. He wasn't doing fine at all. Neither was I. We were doing terribly. It was absurd. We just began to howl.
- In the midst of that he suddenly gave me this very clear look. And I had a sudden thought: "My God, he knows more than I'll ever know about all this. He sees the whole situation." At which point he just scrunched up his face like a clown and gave me this wonderful wink.
- I was just stunned. All I could see was this incredible sense of the humor of things. It was so deep in him. He just had it all in perspective. And he gave that perspective to me. When I left him, my head was spinning. I walked down the hall and looked into the other rooms, at kids I'd known, or so I'd thought, for months. It was totally new. I don't quite know how to describe it. In this room I saw courage. In that room I saw joy. Across the hall, patience. In yet another room, such sweetness: a little body who was so continuously filled with love, people would just— "die," I was going to say. "Live," really. I felt so humbled. I swear I had the impulse to go down on my knees. Here I was, going around giving speech therapy, little lessons, little tips. And what was I receiving in return? Humanity. Basic humanity. The deepest qualities of a person, deeper than you'd see most anywhere. What a gift! How much it helped me in my work! In fact it really changed my life. How often can you say that?
The caregiver receives spirit by being brought out of the straitjacket of the task at hand and into the truth of common humanity. When this spiritual experience is remembered and told as a story, it becomes part of her spirituality. When she retells it, she opens herself to the spiritual possibilities of each new situation. She has developed into a spiritually sensitive speech therapist.
A Story of Giving Spirit
The inner, spiritual dynamics of health care include people giving Spirit. People are not only invited into the spiritual dimension, they are invited to act out of it. I have a friend, a chemotherapy nurse in a children's cancer ward, whose job is to pry for any available vein in an often emaciated arm to give uncomfortable infusions of chemicals that sometimes last as long as twelve hours. He is probably the greatest pain-giver the children meet in their stay in the hospital. Because he has worked so much with his own pain, his heart is very open. He works with his responsibilities in the hospital as a "laying on of hands with love and acceptance." There is little in him that causes him to withdraw, that reinforces the painfulness of the experience for the children. He is warm and encourages them to trust whatever they feel. And it is he whom the children most often ask for at the time they are dying. Although he is the main pain-giver, he is also the main love-giver.
This account reflects a spiritual truth echoed in many religious traditions. His inner work with his own pain allowed him a way of "working with his responsibilities." He draws blood from the soul space, an inner space of love and acceptance. This inner space affects the total experience between himself and the child. He simultaneously gives spirit and takes blood, therefore, he does not reinforce the physical painfulness and move it toward personal suffering. Giving spirit means speaking and acting from the soul space.
These different places affect the quality and effectiveness of what we do. It is not why we are doing something, but where we are at as we do it. Actions done from the soul space are resourced by the spirit that fills and overflows that space. This space elicits a similar space in all who are present. There is power in the spirit as it flows out into the world.
These two examples of receiving and giving spirit reveal a spiritual dimension hidden within the dynamics of social interaction. We work with speech impediments and we receive spirit. We draw blood and we give spirit. These spiritual dynamics are always going on in every situation—in human resources and finance, in legal and operations, in ER and surgery, in the board and examining room. Wherever people gather, spirit is an element of their interaction.
Conclusion
Although it is 6:00 a.m. and still dark, the parking lot of the hospital is already filling up. In a hour only the far lots will be available. People are filing from their cars and meeting up with others who are getting off buses. They are all moving toward the hospital, its many windows spilling light into the last darkness before the day.
Who are these people?
They are spiritual people about to enter into the receiving and giving of spiritual communion. In order to do this, they have brought their spiritualities with them. They have not left them in the homes, communities, churches, synagogues, mosques, and temples that they come from. These spiritualities will give them the capacities to participate in the subtle, mysterious, and renewing ways of the spiritual dimension. All this will happen while healthcare services are also happening. The faith-based hospital, spilling light through its windows, realizes this intermingling of the spiritual with the socially structured delivery of healthcare. It welcomes these people out of the darkness.
