The Minister's Place in the Sick Room

I am persuaded that the minister has a place in the sickroom, obviously not that of a doctor, a psychiatrist, or a social worker. The min­ister's duty there is to rouse the great energies, certainties, and faiths of the Christian religion. If he has Christian faith—and otherwise he has no business in the ministry—he has a great asset, perhaps the greatest asset that a person could have in dealing with the sick. The minister goes to the sickroom because he is the duly recognized representative of Him who said: "I was sick, and ye visited Me.' (See Matt. 25:35, 36,)

This whole passage can be read as a de­scription of the mental and spiritual anguish of any sick man. A sick man is a stranger among strange people. Even his clothes have been changed for a queer abbreviated gown. To be sick is to be stripped of vigor, low in spirit, weakened by lack of determination, feverish by helplessness. To be sick is to pass through strange places with foreboding feelings—the night before an operation with its haunting dreads and imaginings, the taking of the anesthetic, the struggle with postopera­tive discomforts. To be sick is to face the uncertainty of diagnosis, the loneliness of con­valescence, and perhaps even the difficulties of facing life as a cripple or an invalid. To be sick is to be in prison, imprisoned in one bed, one room or ward, imprisoned in one's helplessness with one's handicaps, chained to the threat of death. These are new paths of the spirit.

The minister goes to the sickroom by authority of the needs of the patient, needs which will not be met otherwise. By right of the heritage which is his, he must go to the sick­room. By virtue of the special methods and of the devotion which are his heritage, he must minister to the sick to their advantage, to the advantage of the doctors and nurses who care for the sick, and to the advantage of his own spiritual welfare.

I conclude, therefore, that the minister's opportunity in sickness is to devote himself to the growth of souls at a time when pain, sorrow, and frustration brill.^- experiences that invite a new start in life. The following sug­gestions will, I trust, be of benefit to the pastor in either institutional or parish work.

Special Advice on Work With the Sick

1. Make opportunity to ask the doctor's ad­vice about how you can best help the patient, and let the doctor realize that you wish to forward his plans.

2. Before you see any patient who is seri­ously ill, collect from the family or from the nurse the essential facts about the patient's last twenty-four hours. Study his tempera­ture chart if one is kept, and inquire about his night's rest, his spirits, and previous visitors, if he has had any that day. Be as nearly up to date as you can. Make allowance for any drugs that he may be taking. Clergymen are sometimes puzzled or alarmed by mental and spiritual dullness which is due, not to moral lapses, but to drugs.

3. Let the patient know on what day and at what hour he may expect your next visit, and be punctual in keeping the appointment. If you do not come, and have sent no word, the sufferer's disappointment is keen. Visits help the patient to furnish his empty days with definite anticipations. Your visit can at least serve as an interruption and a change in a long, empty stretch of time. Knowing that you will come, say at five o'clock, makes the other hours pass more quickly.

4. Don't stay too long. Short visits are best. Occasionally we hear the complaint that the chaplain tires sick people by staying on after he should have known enough to leave. This is especially annoying in acute disease and after operations, but it is also true in chronic troubles such as broken bones and broken hearts. How shall he know when to go? He should watch the patient's face and movements. He can learn to read there his signal. As a check on his own judgment he should ask the nurse or an intelligent member of the family to come into the room or to make some move as a suggestion that he has stayed long enough. It is a good rule that when in doubt, he should go, and should pay only slight attention to polite invitations to stay longer. Ten minutes is often long enough with patients acutely sick, and few visits should exceed twenty minutes.

5. Don't allow any alarm, horror, or sorrow to appear in your face or in your voice, if the patient is a close friend and has been blanched and thinned by his illness, it may be hard to conceal your feelings at the first visit. But it is imperative. We have known visitors to break down and cry or to be shocked into a distress­ing silence when they came face to face with a patient who was jaundiced, distorted, or swollen by disease. Experience in a hospital will give the minister control of himself, and he should acquire it before he begins to visit the sick in his own parish. A patient often wants to show you his wound, or exhibit his diseased ap­pendix in a bottle, or the gallstones that have been extracted from his gall bladder. Some nurses and doctors may want to show the minister highly repulsive specimens in which they are interested. He must school himself to be interested, too, and not show his natural feelings of repulsion.

6. Sympathy can be given in a way that does harm. The sufferer should be made to realize that you share his pain; but if you dwell on his feelings, you can unman him. Be does not want to go to pieces or break down emo­tionally. That undermines his self-respect. He wants to know that you are close to him, and especially that you are close to his en­deavor to be the victor, or at least bear up, in this encounter with his enemy. He wants to play the game, as soon as he can learn in and he wants you to play it with him. If it is bereavement that has hit him, he wants you to talk about the person he has loved and lost, and now loves more than ever. To share courage helps him to rebuild. To share the emptiness of loss pulls him down. If it is pain that has gripped him, we can increase that pain by dwelling on it. We can better help him to make headway against it by making sure that he has every available medical aid, by doing the little in our power to make him more comfortable, and then when everything possible has been done, by helping him to turn his attention away from his pain.

7. Remember that the sick have often a sharpened awareness of sights, sounds, and smells. A loud laugh, a loud or harsh voice, may do harm. Yet one should not purr or croon. 

8. Don't jar the bed in entering or leaving the sickroom. Don't lean on it or sit on it. The slightest jar may hurt the patient. Cer­tain people in a sickroom are like a bull in a china shop. Let not the minister be counted among that group.

9. Stand or seat yourself in such a position that the patient can see you without having to strain, by looking up at an angle to his natural line of sight. BY following the direction of his eyes as you approach his bed, you can place your chair conveniently. Be careful not to make him face a strong light from a window behind you. Don't sit in a rocking chair and rock. Rocking tires some patients.

10. The chief object of a visit is to make the sufferer feel that somebody cares about him. If possible, make him feel that many people, his neighbors and friends, care about him, and are interested in all that concerns him. The minister can carry this farther, if anyone can, by making the patient realize that God cares for him, suffers in his suffering, and plans for him in sickness as in health.

11. When you choose topics, exclude all that require close or prolonged attention, or that range far from the interests that the sick man may be expected to keep alive despite his ill­ness. Choose topics near him in space, time; affection, and interest. His family and friends, his own past and future objects in his home or in his room, his favorite hobbies and fa­miliar tastes, are the best starting points.

12. Sick people like variety, change, and lit­tle surprises. The more thought and ingenuity the minister puts into providing them, the more he will excel the average visitor who has no "inspirations" in such matters. Of Course he will have none who gives no thought to the visit until he starts to make it. Vari­ety means much to an invalid, and most of it has to come to him from outside his own house or room, such as a gift or a bit of news. This does not mean, of course, that the sick should be rudely startled.

13. When the illness is chronic but not in­curable, the patient often suffers from a false though natural belief that he will never get well. In such a case the minister, well-forti­fied by the doctor's positive assurances, can do much good by painting the future. Imagine and describe in whimsical detail what the pa­tient will be doing in a month or in six months, whom he will be serving, how he will then look back on his present condition and laugh at the doubts that now torment him. Thus with skill and preparation one can so dramatize the sufferer's future that for a few minutes he lives in it. Here, as in so many other instances, the minister can show by his ingenuity in preparation a quality of devotion that proves him a man of God, and thus prove God to some who doubt Him.

14. Occasionally the sick like a visitor who will chat for a few minutes without looking for a response, and then take his departure. He has given a fresh current to a tired mind; yet he has called for no effort which the pa­tient is not equal to. Such a visit is not very different from a brief period of reading aloud. Some prefer the latter because it obviously calls for no response. Others want to be talked to even though they cannot hold up their end of the conversation. If a patient drops asleep while we read, it may be impor­tant to go on reading as long as our time will allow, because the patient needs the sleep and will usually wake up if we stop. We have to know the patient's habit about this, for some people do not wake when reading ends. Then we can harmlessly slip away for another call.

15. Don't talk of depressing or alarming subjects. A doctor visiting a patient who had been hurt in a motor accident was led to tell her, naturally but stupidly, of another and more serious accident to a child whom he had recently been called to attend. After that he talked pleasantly of other topics, but the impression which stuck in the patient's mind after he left was the horror of the child's injury. Nurses often talk about their lurid hospital experiences in a way to neutralize any good their services confer. The minister should be warned by these blunders.

16. The minister should not take any part in the treatment or practice any special psycho­therapeutic technique. If he does so, he will at once embroil himself with the doctors of his neighborhood, and so will soon spoil his chance of usefulness. He may be well in­formed in the field of mental hygiene, but it is hardly conceivable that he will be ready to take the main responsibility for the patient's illness, and to bear the blame if he does not improve. Since the doctor must bear the re­sponsibility, he should have a free hand with­out any interference from anyone.

17. The minister should never let himself be drawn into any discussion with the patient or his family about the value of the doctor's treatment. If they have doubt about it, it is for them to ask the doctor to bring a con­sultant. They have a perfect right to suggest this, and to suggest also what consultant they would like to have. The doctor hardly ever makes an objection. In the extraordinarily rare instance in which the doctor refuses a con­sultant, the family or the patient can always discharge him and engage any other doctor whom they prefer. But in all this the minister can take no part, unless the family ignorantly think they must stick to the doctor whom they have called first. Then the minister should inform them of their rights. But except in cases of flagrant abuse or neglect, he should refuse to discuss the question of whether the present treatment is effective or not.

18. The minister, like the doctor, must keep many secrets and hold much in reserve, but he must absolutely tell no lies to, or about, the sick. This is not always easy. Some doctors believe in deceiving patients—for their own good, of course—and if the minister is to keep on good terms with the doctor, it is sometimes hard not to take part in such plans of deception. If asked by a patient or by his family any question about the disease and its prospects of cure, the only safe course for the minister is to "decline jurisdiction." "Have you asked the doctor ?" should then be the question on the minister's lips. It is not his business to have opinions about diagnoses or treatments. If the patient asks, "Do you think I am going to get well?" he should answer, "That's what we are all working and hoping for, but I know nothing of such matters. I'm often frightened by illnesses that the doctor knows are not serious at all. I do know, because doctors all say so, that your deter­mination to get well will help to cure you."

19. Don't whisper or speak in low tones to a nurse, to a member of the family, or to anyone else in the sickroom or near it, if there is the slightest chance that the patient will see you or hear you. Your conversation may have nothing to do with him. It may contain only what you would gladly have him hear. Nevertheless he is apt to think that you are saying something too alarming for his ear. Such a belief is like poison to him. It will do him far more harm than any visit can do him good. Whenever it is possible, say what you have to say about the patient in his presence. Don't let him fall to wondering what you and they are saying about him down­stairs or in the next room. If in a home, leave the house, and if possible close the street door loudly enough to let him know that you have gone, soon after you hid him good-by. When you need to talk at length with someone in the family, have him come to see you. Don't walk on tiptoe unless the patient is dozing or is asleep, or unless you know on reliable au­thority that the patient prefers you to do so, as many patients are irritated or alarmed by it.

20. Train parishioners to have you called when they are ill. Perhaps the last incumbent of your pulpit did not care to visit the sick. Few do, but people need to be informed through various channels that you regard visit­ing the sick as one of your privileges.