Book Review
by Larry Toney
Soul Support – Spiritual Encounters at Life’s End – Memoir of a Hospital Chaplain by Joan Paddock Maxwell, Resource Publications, Eugene, Oregon, 2017.
In the prologue of Joan Maxwell’s helpful book, Soul Support Spiritual Encounters at Life’s End, the author tells us the purpose of her book, to share “holy encounters between the human spirit and the divine” (p. ix). In order to accomplish this, Maxwell divides her 217-page book into three broad sections: Listening, Learning, and Loving. Readers will accompany the book’s writer as she takes them with her into the acute care areas of a large metropolitan medical center in Washington, DC. Along the journey, Maxwell gives her followers a number of good quotes they can add to their clinical pastoral care tool-box. Among them are the following:
“If patients want to talk about (death), bringing up death is a gift to them” (p. 9).
“Who is in charge? The official answer, as it is true of all interactions between staff and patients, is that the patient is in charge” (p. 48).
“The chaplain needs to find a way to let the patient know that a chaplain may have something more than ‘religion’ to offer” (p. 49).
“If a patient cried, instead of politely ignoring the tears…I would gently say, ‘What are those tears about?’ To my astonishment, people were usually eager to answer” (p. 49).
“If the patient was a religious believer, I would often ask, ‘What role do you think God is playing in your illness?’” (p. 49).
“Hospital patients are consigned to remarkable anonymity. They are nude under the same flimsy and inadequate gowns, in interchangeable rooms…and the hair of both sexes is often uncombed…” (p. 91).
“Over the years, I have come to know that words will be given to me if I just get out of the way…(so) I stopped using the ‘forms’ of set prayers. I simply listened to the patients with an open heart….Before I began, I would…(say) something like, ‘Can you tell me what you want the prayer to include?” (p. 112).
“In chaplaincy training we were told to touch dead bodies as a way of encouraging families and friends to do the same” (p. 118).
Maxwell makes keen observations from her work as a hospital chaplain through her stories. Her observations could provide excellent discussion starters for people interested in pastoral care, or for conversation at a pastor’s meeting, or as starting points for dialogue a supervisor of Clinical Pastoral Education could use with their students.
Maxwell worked as a chaplain in three acute-care hospitals and served as a palliative care chaplain in one of them. She received a Master of Theological Studies from Wesley Theological Seminary and was endorsed as a hospital chaplain by the Episcopal Church. Ms. Maxwell is knowledgeable about clinical ministry and kept a significant record of her experiences, which were the basis for her book.
One concern the reader might have is that Maxwell does not possess the standard master-of-divinity or doctoral theology degree. This is important because the work of pastoral theology and pastoral counseling is hard work and requires the ability to reflect deeply and critically in both conventional theology and contemporary psychological practice. When a person does not possess in-depth theological study, it places more responsibility on the reader. One example comes at page 66, when Maxwell talks about her office in Palliative Care. She writes: “The palliative care office was the size of two narrow closets, one next to the other. There were no windows.” The author could have used the size of the Palliative Care office to talk at length about what the size of the office says about the importance of Palliative Care to the hospital. I suspect a small, windowless office is a sad indicator of the value the hospital places on the important work of palliative care professionals. Another example comes in the book’s afterward (p. 202), where Maxwell spends two pages discussing how the contributions of hospital chaplains have been marginalized and even eliminated in many clinical settings. The author believes hospital chaplains have “a positive effect” on the well-being of patients and staff. I agree with the author, but her point could have been made more strongly. I suspect her views on the importance of faith have been diluted by the political climate, the place of science in the medical community, and the view of the insurance industry. Maxwell could have pushed back much harder in her writing on the importance of spirituality. For example, 90% of Americans believe in a higher power; 80% of Americans pray. Poll after poll tells us Americans are a spiritual people and when they are in an acute or palliative care setting, they are wrestling with challenging existential and/or spiritual issues. The primary person in a medical center who can help them with these issues is the chaplain.
A number of books, starting with the writing first done by Larry Dossey, have demonstrated that faith can play a critical role in the healing process. This was also powerfully illustrated in Kenneth Pargament’s book, Spiritually Integrated Psychotherapy, where he lamented the failure of psychology to appreciate the important place religion and spirituality have for the overwhelming majority of Americans. Likewise, Crossroads, a journal from Duke University that traces the intersection of spirituality, theology, and health, reports monthly on studies that demonstrate how religious well-being is tied to better health. Chaplains have no need to be meek about their work. It is important and is a proven means to help patients, family members, and staff cope with the issues of pain and loss they encounter daily.
I am grateful for Maxwell’s book. She is a superb story-teller. The author possesses excellent insights into what pastoral ministry looks like in a medical center. The book would be a superb read for someone with limited experience in a clinical setting or for a student in their first pastoral care class.
