17 Spiritual consult

When a patient really needs a chaplain.

The patient had requested a “spiritual consult”. We never know exactly what that means. We always go.

This time it meant that the patient just wanted to talk a little. About her life, about faith. There was nothing pressing, it seemed. And I thought about wrapping it up in our polite “It was nice to meet you” way. But something prompted me to stay.

Even when the heart doc stopped by, I stayed. Rather than walking in, he stuck his head in. He gave her a brief update about what he wasn’t going to do in the next day. He seemed anxious to let me have my time, as anxious as I usually am to let families have doctor time.

Often when I walk into a room, I’m stopping by unrequested. I’m following up on a trauma patient. I’m following up on a new admit who didn’t have any religious affiliation indicated. I’m on an intensive care floor or in oncology just checking on people.

In those cases, families often look at me hopefully and then I have to explain that I’m not the doctor, at least not the kind that they are looking for. I explain that I don’t have the answers that they are looking for. And when the medical doctor comes, I leave. I know that often, the conversation they most want is with the person who has medical information.

But on this day, with this patient, it was the heart doc that was ready to leave, sensing that I was the one the patient needed.

He left. The patient and I kept talking. And slowly I became aware of the real heart issue. There had been a difficult family situation decades before. The grandmother in front of me lamented the pain a granddaughter had suffered back then, relational pain that still has not healed.

Eventually it was time to leave, but with prayer specifically for grandmother and granddaughter. It’s beyond my capacity to enter into the relationship, to try to fix it. But by acknowledging it in the presence of this grandmother and God, I was part of the work.

There is research about the connection between spiritual conversations and patient satisfaction. One study found that forty percent of patients had a desire to talk about spiritual or religious questions while in the hospital. Only half of those conversations happened. When they did, patients reported high satisfaction, overall.[1]

As I reflected on the conversation with this patient, and the tiny interaction with the heart doc, I got a glimpse into that research. The patient had indicated the desire. She was in the forty percent. I came. She was having the opportunity for the conversation. Even as the medical doctor came, that wasn’t the most important need to her at the moment. Because it wasn’t simply a visit from a chaplain that she needed. It was a conversation with a chaplain, one that was slow enough and present enough to allow part of the cause for the underlying pain to emerge.

I have no way to know whether she was “satisfied.” In fact, the tears in her eyes as I was praying would suggest to a casual observer that my visit brought pain rather than satisfaction. But this one time, I think, our hospital accomplished the balance of whole person help that we are striving for.


  1. Joshua A Williams, et. al. "Attention to inpatients' religious and spiritual concerns: predictors and association with patient satisfaction." Journal of General Internal Medicine 26:11 (2011): 1265-1271.

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Spiritual consult Copyright © 2018 by Jon Charles Swanson. All Rights Reserved.

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