Wednesday, July 8, 2009

The Unwonderful Land of Or...

Imagine a scene in a private hospital in a medium-sized city, part of a sprawling string of metropolitan, suburban, and beach communities in the Middle Atlantic region of the United States.  Visualize a windowless room perhaps 15' x 8' (5 x 2.7 m), with nine people sitting in a ring, one of those people a candidate for a residency in hospital chaplaincy training.  Listen as the first seven to ask questions do so by reading, rote, from a list of questions supplied to the candidate twenty minutes in advance of the interview.  

Only the last two interviewers made the assigned questions assigned come alive as interesting, worthy of serious thought, though deadpanned with a lack of affect that left just the barest opening for connection, until the interview had ended.  True, one of the others had smiled; she had then fallen behind the mask of impersonality as she read her question with virtually no expression.  The candidate, a former academic used to intellectual exchange, found all this affectlessness baffling, and never performed up to ability until the last two, interesting questions.  Most baffling of all:  the committee seemed to find the candidate's performance baffling, and sub-par, except for the responses to the final two questions. 

Now consider the same room about an hour later.  The director of chaplaincy services remains, but three new colleagues have joined him.  Whereas the first group included, along with the medical professionals involved in training the residents, only two chaplains--the director and the one who asked the interesting question interestingly--the second consisted of nothing but chaplains, two in their thirties, the others in their sixties.  Here the script consisted only of the candidate's application, a series of essays-cum-resume that in this case came to about eleven pages.  The conversation could not have gone more differently, even though the candidate had a moment of fear at first, wondering if he would find a way to connect with these people.  The doubts dissipated in the first five-to-ten minutes, amid a blitz of challenging questions, careful consideration of the responses, and even the occasional bit of laughter.  An interesting conversation which ended with the candidate judged to have done well.  

The candidate learned the opinions of the two committees after about a forty-five minute wait in the parking garage, the hallway, even the adjacent sidewalk briefly.  It felt a bit like the wait after a Ph.D. oral examination.  The answer:  maybe.

For the candidate, an afternoon in the unwonderful land of or...

The difference between the two experiences--mine, two days ago--makes one wonder a number of things, beginning with whether a residency at that particular hospital would work.  A degree of ambivalence still characterizes my thoughts about hospital chaplaincy, even as the opportunity to walk around with a chaplaincy intern fifteen or so years my senior helped me, at least in retrospect, see myself in such a setting, and even imagine a specialty in mental health.  Or...

One also has to consider the conservative culture of the region itself.  This again speaks to fit, and reminds me of struggles, one considerably more successful than the other, waged in two earlier periods of my life in the same state, though in areas distinctly different from each other and from this one, and neither near my great protectress, the sea.  Or...

Then comes the issue that seems most striking and important.  The culture of medicine places professionalism ahead of personality, partly as a protective shield against burnout, but also as an extension of the notion of medicine as science.  It strikes me as more honest to call it an art practiced with the benefit of scientific knowledge, something a bit different, if not another thing altogether.  One strongly suspects people who buy into the scientific model of left-brain dominance.

The culture of ministry, on the other hand, when not given over to the academic practice of theology, tends to encourage contact with the real person seeking consolation or guidance.  Ministry requires some of the same persona-as-self-preservation that one sees in medicine, especially in a hospital environment--hence my initial moment in the second interview of wondering how to make contact with the group--but with an enormous and even existential difference.  Chaplains, doctors, and nurses all manage a series of critical and uncritical moments aimed at the hope of a successful outcome.  

One suspects, though, that a chaplain would find a successful outcome harder to specify, let alone judge.  For all the improvisational character of the practice of medicine that leads one to call it an art, chaplaincy draws personalities much more likely to demonstrate right-brain dominance.  Chaplains work from training, but also from instinct and faith, from an ability to empathize without losing sight of the patient's--and the patient's family's, or both at once and sometimes against each other's--best interest.  Different job description, different skill set, likely to appeal to very differently personalities from those to whom practicing medicine appeals.  Or.. 

1 comment:

  1. Sometimes, I think that hospitals and God do not go together, that God is waiting for us on the outside, praying for our swift recovery. Hospitals are so white, so expressionless, so desperate sometimes.

    I see the crucial nature of the hospital chaplaincy. I see how difficult it must be to be in the midst of such fear, suffering and yes, joy. I see the role of the chaplain as someone who is constantly breaking the ice, even among family members.

    I got antsy just reading about the interview process. It is such a challenging ritual we put ourselves through. Why is it that interviews go on so long when often the minds are made up much sooner.

    I applaud you for jumping in. This work is deep, wide and so meaningful.