by G. Michael Horwitz
I am a staff Chaplain at the University of Alabama at Birmingham Hospital, the largest medical system in the state of Alabama and the only level 1 trauma center in the state, with patients every day from over 10 different states. While my particular role is seeing cardiology and pulmonary patients on various inpatient, outpatient and 10 different ICU units, we now are very involved in the outskirts of the COVID-19 care.
I begin my work day with a chance to gather with staff on various units to share information, support one another, and pray together. Our full time, part time and chaplain residents made up of about 35 individuals — at UAB we probably have among the largest pastoral care departments in the entire country — are still working our regular shifts and want to be at work and love what we do. While many are needing, required or encouraged to stay home, I do not have that as an option and am fine with that.
I want to share a few things about the current situation for me and medical staff in general, and other chaplains and medical staff I have been in touch with around the country. Therefore, some of this is from my firsthand experience. Some of it is from serving alongside others who have shared their stories with me. But before I do, let me add that social distancing does not exist in the same way in the medical profession. We do the best we can.
I am proud to be part of the interdisciplinary team here at the hospital and the only Jewish chaplain on staff.
Here are a few things you should know:
1. Chaplains are not allowed to see any patients face to face right now in rooms that have COVID-19 or are under investigation for it. From my understanding, this is true across the country.
We have about 100 in our hospital in that category as of now, but surely will unfortunately have more. If these patients are actively dying, we can’t be there other than to talk to family in a waiting area. We are calling patients over the phone or videoconferencing (if they can talk). We are praying in the hallways. We are encouraging exhausted and anxious staff as best we can.
I quote one chaplain who said “It feels like every tool we normally use to provide ministry has been taken away.” No outside clergy are able to visit here either, and I am not able to visit patients in other hospitals as well.
2. Every medical professional is overstressed right now. Obviously, many are on the front lines, caring directly for COVID-19 patients. Others are trying to do their normal job with lots of restrictions and just waiting for: (1) the virus to enter their domain or (2) the call to be reassigned to the front lines. Experienced doctors are pronouncing death for the first time in their careers. Outpatient nurses are suddenly reassigned to intensive care. Things are literally changing by the minute. So it’s not just the virus. It is the unending uncertainty of the situation that wears you down.
3. COVID-19 is a horrible way to die, and people are dying daily. You are most likely alone. Perhaps you are fortunate enough to have one family member with you who is very restricted in how they can comfort you in your last moments. You can’t breathe. That is perhaps the most distressing feeling that you can experience at end of life. As of March 29, Alabama has about 11 COVID-19 deaths and none yet have been at our hospital. But this will change, unfortunately. We and other hospitals have already closed some units to prepare for the influx of patients that is coming in the near future.
4. Yet, God is walking up and down our hallways and bringing a supernatural peace. I’ve already seen amazing things happen in the hearts and souls of my fellow health care workers. These moments can refine us and make us stronger. They can bind us together. We can find the sacred in the midst of the chaos. As a cantor, I use my voice in many different ways through singing, spoken word, silence and now new ways amidst this ever-changing situation.
5. We are used to bringing families to the morgue (at UAB it is called “office of decedent affairs”). Sometimes in large groups. I do this often. However, now only one person period is able to go to the morgue and the family is faced with choosing who that one person is to be. While it is true that families can do this at the funeral home, many like to do it at the hospital, especially those who want to say their final goodbyes and missed being at the hospital when their loved one died.
6. I have been with a few families so far when a loved one has died during this time our world faces. Special arrangements are made so families can be present whenever possible or brought to a conference room or waiting room. It’s a very difficult situation for them and I feel blessed to be part of their experience offering comfort.
We have no visitors permitted in the hospital. It is a very quiet place now in the hallways for the most part. Surgical waiting rooms are empty. Some units are closed, being remodeled or prepared for additional ICU beds as the coronavirus continues to spread.
We are preparing. We wear masks. Sometimes we need to wear the same ones more than one day at a time. Some wear them up to one week. Many special circumstances exist now regarding that situation that I can’t even elaborate on, because it makes my head spin as every day we receive emails and updates about the changes and protocols.
7. Pastoral Care staff meet to talk and learn from one another and are very respected and appreciated at all times, but especially during this crisis. We have a list of resources, prayers, songs, etc., on our website for people to access specifically for Coronavirus, led by members of our teams of chaplains individually, including myself. Other hospitals are likely doing the same.
So I ask that you pray. I ask that you help and support in ways that you can. I ask that you empathize with those that you know personally as well as those that you don’t know who are touched by the virus. Don’t forget that many people still go to work every day as they were before this happened, and will continue to do so to help others and be encouraging.
I am sure it is very difficult in congregations of all faiths now. May Pesach be an opportunity as always, but especially in 2020, for a time for creativity and love in whatever way possible.
A favorite quote comes to my mind during this time that was on the chapel door window in my previous hospital in Virginia. “I care more about the person who has the disease then what disease the person has.” Unfortunately, that quote is very difficult to put into action and one that I now struggle with in new ways. I think we all do.
And remember to sing even if nobody can hear you.