Tricks of the trade

It's easy to learn about being a chaplain. It's much harder becoming one. Applying book learning is difficult when you're sitting next to someone who doesn't respond and you're thinking, "O dear God, what do I do next?" Time seems to expand, minutes turning into hours, as you sit and think of every possible intervention. You try one. No response. You desperately try another. No response. A third. "How did the previous chaplain manage to spend 30 minutes with this person," you wonder. And then you start to learn the secrets and the tricks of the trade.

The hardest thing to learn is to do nothing. I learned it from some of my Christian colleagues - Ministry of Presence - or, as a friend explained it to me: "Don't just do something, stand there!" It's difficult to just be with someone; to stay in the moment. It's easy to have your mind wander. "What will I cook for dinner?" "Have I been here too long - what will the traffic be like when I leave?" But when I stay in the moment, I connect with patients. They know I'm there. That's one of the interesting things about dementia. A patient who can no longer talk can't be fooled by words, by a "chipper" tone of voice, by a fake smile. They read body language. They know if I'm not present. Often when I relax, they relax. When I really smile at them or laugh, they smile and laugh in return. We make a connection. In that connection, we transcend the boundaries of time. Instead of minutes turning into hours, time ceases to matter. We're just there, in the moment, together.

I've learned other "tricks" in my work. But the best, the most useful, and some days the hardest of all, is to just be there.

"Can you hear?"

I was sitting with a new patient as part of my initial assessment. The following conversation took place:

Patient to me: "Can you hear?"

Me, puzzled: "Yes?"

Patient: "What do you hear?"

Me, listening intently: "I hear a machine running on the other side of the room."

Silence.

More silence.

Then I asked: "What do you hear?"

Patient: "Voices."

No answer as to what the voices were saying. I sat silently while my patient looked off in the distance and continued to listen.