Reflections from a CPE student and hospice volunteer in a VA medical center

In 2004, I began my Clinical Pastoral Education (CPE) experience at a Veterans Administration (VA) medical center. For two years I worked at this facility’s hospice program. I was interested in becoming a bereavement counselor for hospice. As a student chaplain, I could not proselytize. I had to respect a variety of beliefs, though I was not required to participate in his or her practices if someone was of a different faith and needed a chaplain. I could get someone to fulfill those obligations. I did not have to proselytize. I watched God in action.

I could tell the veterans God loved them. If it opened conversation, the Spirit had already prepared them. If not, then they were not ready to hear. The VA required a visit to each patient admitted to the hospital or nursing home. When we approached veterans for the first time, on admission, we asked several questions as to who they were and if they belonged to a particular faith. From their responses, sometimes we could tell if this was a conversation that may need to be addressed.

Some veterans blatantly said they wanted nothing more to do with us. We respected this. In one conversation I asked the patient, “What would it take for you to believe?” He told me. I said I would pray for that for him. I still pray for him. Some patients did not want to talk about faith; some avoided me or just talked about other things. This was fine because my emphasis was to show God’s love and let his Spirit do the work. I asked friends to pray for the work, giving no names.

Some responses were mild and more difficult to discern how close to God they felt. Questions like, “Would you like for us to contact your pastor” and, “Do you want us to contact anyone” helped find what kind of social support they had. We made sure we visited those with little or no support. We made follow-up visits to those having surgery and those who requested a visit. We also visited hospital staff in difficult situations.

Music: As a hospice volunteer, I regularly visited patients/residents. One patient was a retired chaplain I visited for support, prayer and encouragement. I took my guitar and asked if they wanted to hear music. Music opened doors that otherwise have been closed to me. I played quiet music, more in the classical style. I did not push but asked if they had any requests. If there was doubt, I invited them to listen to a song. Then they could tell me if they wanted more or not. Some were afraid I might play loud; they did not want loud music. For some patients I just asked the questions I was to ask on each visit:

1. How are you feeling?
2. What do you need to make your stay more pleasant? (I reported this to the chaplain’s office.)
3. Any complaints? ( I also reported this to the chaplain’s office.)
4. What yet needs to be done?

Before I left I asked if they had any prayer requests; I kept them in my prayers. When patients were not in their rooms, I left cards, encouraging them and stating I would pray for them during the week.

A Jewish patient in the end told me she “had prayed the Lord’s Prayer” when I asked her if there was anything yet to be done. One patient said there were too many rules in church about dress and so forth. I replied, “You have not been in church lately.” When our church came to sing, I pointed out our pastor, who was not wearing a suit and tie. When I asked this patient if he had a request, he asked for “Just a Closer Walk With Thee” and “Amazing Grace.”

A study on music says, “Music can bring hope to an unpredictable world.” Many requested hymns. I was often asked to play “Jesus Loves Me.” A resident with dementia asked for “O How I Love Jesus” and sang the chorus even as the dementia robbed him of the rest of his memory. One weak patient became energized as he taught me a song I did not know.

Residents not in hospice asked me to play for them. We met in the lounge near the nurse’s station. One resident shared with me how music had brought him out of a coma. An older resident asked me to play a variety of hymns; a group of patients gathered. He asked if there were hymnals we could use. The activities director opened the door where hymnals were kept for Sunday, and we passed them out. That day about 20 men gathered, singing old hymns such as “I’ll Fly Away” and “Amazing Grace.”

PTSD: I became aware through research the impact of natural life events such as deaths of loved ones can have on a veteran’s life. Veterans who did not have symptoms of post-traumatic stress disorder (PTSD) had symptoms and sought help after 9/11 and when the Gulf War and the Iraq War began.

What is PTSD? One writer says: “Survivors of (life-threatening) trauma may be angry, irritable or depressed. If symptoms continue longer than a month, PTSD is diagnosed.” The definition of PTSD keeps changing, but basically it is delayed grief and regret due to the effects of trauma. Trauma often leaves an individual emotionally at the age he or she was at the time of the trauma. Isolation is often a result of PTSD.

The current wars with Iraq and Afghanistan are going to yield their own unique problems. War is hell; however, those involved are still some of God’s precious children. We must learn to separate the veteran from the war. Not every one is “evil.” God still sees potential in every individual. We are at war because someone decided that the “other” was evil, insinuating that we are “good.” The Bible says, “All have sinned and fall short of the glory of God” (Romans 3:23).

Some veterans have seen atrocities. Guilt can come from just surviving when others were killed. The relationship of a soldier to his or her comrades is similar to that of Jonathan and David. The path back to wholeness can be a long one. It takes a community to help in that healing.

Here are some good resources:

• John Shay’s The Achilles in Vietnam: Combat Trauma and the Undoing of Character;
• William Mahedy’s Out of the Night: the Spiritual Journey of Vietnam Vets;
• NCPTSD: www.ncptsd.va.gov/; NCPTSD@va.gov.

Part of my training was “Listen and Love,” from which came “Listen, Care and Be Aware.”
Listen: Listening is the greatest part of your ministry to the veteran. Needed are people “who are natural healers, those who have time to listen.” The word compassion means “to suffer with.” How can you help if you do not know what is happening? Listening provides the veteran with the opportunity to share with you when he or she is ready. It is not something you can fix. Healing is in God’s timing. Building trusting relationships take a long time, yet that is what the veteran needs. Do not try to “fix it” with Scripture. Scripture has its place but given at the wrong times sounds like you are in a hurry and not really interested. Listen also to the veteran’s family.

Care: You show care by giving feedback. Feedback is when you state what you heard in order to get clarification, to understand better. This also helps minimize misunderstandings. Give time for the individual to answer if you ask questions. You do not want to cause any more spiritual pain by giving wrong advice. If the veteran shows emotion, share that emotion; do not try to fix it by saying something. Share the moment. If you say anything, wait a while, then say, “Thanks for sharing that with me.” Treat it like a treasure. It is. Care also for the veteran’s family.

Be aware of current events in a veteran’s life. How do current events, such as 9/11 and wars, affect one who has experienced combat or other trauma. Be aware of possible triggers. How are these triggers affecting him or her? A murder, war or death of a relative can affect a veteran in surprising ways, even to him or her. Also be aware of the stage of life the veteran is in. Retirement and death of a spouse can trigger PTSD. Be aware of how grief affects us. Be aware that you will need good boundaries for yourself to prevent burnout. Then witness God in his work. You do not have to convince the veteran; that is the work of the Holy Spirit.

How can we as Mennonites, who likely have not experienced the trauma of war, reach out to veterans? We state in our vision that the church is a place of healing and hope. Community is important for healing; families of the veterans may need support, too, not just the veteran. Those who are more aloof are the ones who need us to reach out to them. Families of veterans who do not admit needing help may need help the most. Discomfort is often part of the scenario for those who give care. Needed are those who are willing to show compassion, listen and make time for veterans. One writer says, “Until suffering is seen as something to be heard and not a problem to be solved (or fixed), the pain people feel as they die may never see the light of day.” Is this not the work of the church? Our vision is of healing and hope.

Pat Schosser lives in Burnsville, N.C.