Offering comfort amid crisis

By LINDA GIBSON

© St. Petersburg Times, published March 14, 2000

TAMPA- Tim Longland's pager went off at 8 p.m. one recent Saturday. A stabbing victim was on his way to Tampa General Hospital's emergency room.

As the chaplain on call, Longland got paged for all trauma cases arriving that night.

The victim this time, 21-year-old Jamie Butler, had been stabbed in the heart by a hitchhiker. He was so near death doctors cracked open his chest right there in the ER. While a dozen people worked to save his life, his companion of three years, Corina Butler-Zahn, stood by in shock.

She had witnessed the stabbing and taken the frantic ride in the ambulance with him. Doctors told her Butler had only a 1 percent chance of surviving.

"I was scared and had no one to talk to. I was here by myself," Butler-Zahn recalled.

Longland was supposed to comfort her.

Most people probably would wonder what to say. But in the six months Longland has spent in Tampa General's pastoral care program, he has learned that's often not the point.

"Sometimes, words just don't work," he said. "Sometimes we just sit and hold their hand."

Longland, 56, is one of six students going through the intensive, nine-month residency required for national certification as a hospital chaplain. Hundreds of hospitals around the country offer such training.

The three full-time chaplains at TGH and their students often are the first to speak to families of patients taken to the emergency room. They notify next-of-kin that a family member has suffered a stroke, or been in a car accident or a violent attack -- whatever brought the patient to the hospital.

And if the patient dies before his family could be found, a chaplain breaks the news in person after first asking the family to come to the hospital.

"They're not just Scripture readers or patters-on-the-head," said David Gerber, director of pastoral care at All Children's Hospital in St. Petersburg and a member of the national board that certifies chaplains. At All Children's, questions about organ donation, patients' rights, ethics and end-of-life care are settled in the pastoral department.

"It's a profession. It takes a lot of training to do the job right," he said.

Most students already are ordained but want to work as hospital chaplains or enhance their skills in dealing with parishioners in crisis. They come from various religions. The faiths of the current group of students and supervisors at TGH include Judaism, United Methodist, Presbyterian, Pentecostal, Assembly of God and Southern Baptist. They don't limit themselves to patients of their own faith, and much of their work has nothing to do with religion.

When they're finished, some will return to their churches or work for hospitals. Others, like Longland, will seek jobs in fields such as hospice care.

Hospital chaplains earn about $35,000 a year or more, but there's not a big demand for them. Florida law requires Level-1 trauma centers to have chaplains available 24 hours a day. Some hospitals, however, often view them as overhead: They don't generate revenue.

But there can be financial benefits for hospitals with chaplains, their advocates say.

Some studies show that patients in hospitals with extensive chaplain services spend less time in the hospital and need less medication, said the Rev. William Baugh, TGH's director of pastoral care. And patients who see a chaplain may be less likely to sue.

"We've always argued that we're revenue enhancers," said Gerber.

Chaplains can help families struggling with life-or-death choices reach a decision more quickly and with less emotional distress than those left on their own, he said.

Should life support be ended? Should organs be donated? Delays in those decisions tend to cost the hospital money, but pressuring families to decide quickly can make them angry enough to sue later.

"If it's handled poorly, the family is going to feel abused," said Gerber. "Chaplains are a very good insurance policy."

Tampa General chose to offer the residency for the prestige, said Baugh. The TGH students pay $1,100 for the training, and the hospital pays the students $13,500.

Because TGH offers so many specialty services, chaplains see a huge variety of patients: burn victims, dying children, organ donors. More typical tasks include comforting patients and families or helping patients write living wills.

Baugh, 59, and two other supervising chaplains carefully coach their students about how to handle themselves with people in crisis.

"No one wants to be with someone in agony," he said. "It's counter-intuitive. Our instinct is to run. We need to be sensitive to the ways in which we run. These become increasingly subtle." These techniques include walking out of a room where someone is in pain or just tuning out the pain.

Longland, who was ordained by the Assemblies of God, said his first instinct used to be to save the person's soul by quoting Scripture.

"I've become a lot less dogmatic," he said. "I've learned to not always have the quick and ready answer. Listening is more important than speaking."

But the student chaplains routinely go far beyond just listening.

One student, Baugh said, spent hours trying to find a Buddhist monk who spoke Vietnamese for the family of a 9-year-old girl.

In the case of Jamie Butler, Longland ended his 12-hour overnight shift by driving to the state fairgrounds to find his brother to notify him of Butler's injury before driving home to Clearwater.

Ms. Butler-Zahn, 37, relied on the chaplains to feed her a couple of meals the day after Butler's stabbing. Police had impounded her car and her purse as evidence.

She also asked a chaplain for help when Butler became uncooperative with the staff, complaining about them and pulling out tubes. One of the chaplains befriended him, giving him someone to complain to.

Butler-Zahn, meanwhile, went often to the pastoral care office to unload.

"I visit all the time," she said. "If you want to talk about religion, they will, but they're not preaching."

Most likely, they're listening. The program places special emphasis on letting the patient tell the chaplain whatever the patient needs to say.

"The privilege of being with people on that journey, either toward death or healing, is incredible," said Baugh. "There's nothing more special."

-- Linda Gibson can be reached at (813) 226-3382 or gibson@sptimes.com.

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