Hospital Chaplaincy as a Catholic Laywoman

Clinical Pastoral Education (CPE) is a common summer undertaking for seminarians. Many large hospitals offer the intensive summer program, which challenges us to put all those lofty ideals into action. At Bellevue Hospital in New York, I spend three days a week offering pastoral care to some of the most underprivileged patients in the city. Bellevue was the nation’s first public hospital, and its “preferential option for the poor” means that the patients I see are rarely “just sick” – they often experience a range of compounding systemic issues, which may include homelessness, undocumented immigration status, addiction, incarceration, or abuse. A significant percentage of these disadvantaged patients are Catholic.

Over the past few months, I’ve seen people die. I’ve sat with extended families while they weep over the loss of their loved one. I’ve heard people curse at God or threaten suicide or rail against the hospital system or cry over the fragility of their tiny premature baby. I’ve conducted dozens of pastoral care visits in Spanish – and struggled to make myself understood to patients who speak only Mandarin, French, Russian, or Arabic. 

When not visiting patients, my CPE classmates and I spend two days a week presenting papers about our patient visits, sitting in didactics on subjects ranging from family systems theory to organ donation, and doing process group, an hour-long slot dedicated to our emotional experience (it’s like group therapy – but harder). We attend different seminaries and profess different traditions: aside from me, a left-leaning Catholic laywoman, our group includes a Reform rabbinical student, a Buddhist nun, a religiously unaffiliated student, an A.M.E. Zion Christian, and a Catholic priest-in-training. Only a few of us will be ordained. Emotions run high and we confront each other about theology, politics, and all kinds of transference, a term that describes what happens when we project the ghosts of our pasts onto present relationships.

I often ask myself: Why? Why am I putting myself through this? When my supervisor talks about how to apply lessons in our congregations, I’m reminded that I will never have a congregation. Hospital chaplaincy is a wonderful thing, but I don’t think it’s my chosen career. Many of my classmates at Union Theological Seminary are required to complete a unit of CPE as they pursue ordination in their mainline Protestant denominations; I have no such requirement as a Catholic woman, of course, as the institutional Catholic Church usually appears supremely uninterested in my theological or pastoral formation.

And yet – here I am. While working at a Catholic Worker house last fall, I had a sort of epiphany: a woman told me “don’t be alarmed” and pulled up her shirt to show me where gangrene had eaten away at her breast. Despite her exhortation, I was alarmed. In that moment, I decided, wow, I need to do a hospital unit of CPE. I wanted to be more present for people, particularly women, who are in the midst of crises or trauma that I have never experienced. Though I may not have a clear sense of my own vocation, I figured that learning to better accompany people in distress would be an important part of my discernment.

If you have any preconceived notion of a hospital chaplain, you probably picture a priest sweeping in to administer the Anointing of the Sick or a kindly nun stopping by to offer communion. My classmates and I are not trained as “religious goods salespeople” (as we are often reminded when our limited supply of Bibles begins to dwindle) – we are learning to offer pastoral care. This means that we sit with people and help them process their emotional and spiritual experience. We don’t “give” them anything concrete; we listen to their feelings and help to shape their struggle to make meaning of their lives. When a patient wants to pray, we pray. In theory, though, a Jewish chaplain can care for a Catholic patient’s pastoral needs just as well as a priest can. The key is not religious commonality but pastoral presence, the ability to sit with someone in the midst of pain or grief or fear.

There are advantages and disadvantages to being a laywoman and a chaplain. The most obvious disadvantage, of course, is that some people still want a priest. I cannot perform the sacraments. Some patients understandably want a priest at the end of their lives – the priest symbolizes God’s presence in a way that I cannot. As a woman, I do not incarnate Christ in a hospital room in the same way that my ordained colleagues do. While I am learning to cultivate my pastoral authority, I lack their ordained authority.

Another thorn in my side is that while I receive the same training as my Catholic seminarian peers, our community has no intention of ordaining me at the end of this process. In the eyes of the hierarchical church, my body is more determinative than my pastoral competency.

On the other hand, though, my lay perspective can help me get closer to the patients’ pain. Many priests go into the hospital as sacrament dispensers: they bring the oil or the host, say the right words, and then disappear. Pastoral care is harder. It demands emotional investment, presence, and self-awareness. Without the tools of a priest, I have fewer tricks up my sleeve, so to speak. I go into a hospital room with nothing but myself, which brings me right up against the situation at hand.

Most importantly, I’m working on myself. CPE demands that students plumb the depths of their selves, untangle their transference, and figure out what kinds of blockades we put up to avoid being emotionally present with patients and others in our lives. It’s draining, destabilizing work – but it’s also deeply generative. I’m practicing presence. I’m discerning my commitments, my hopes, my biases, and my fears. In hospital rooms and around a table with my classmates, I’m becoming more intensely myself. I’m not all the way there – and I never will be – but right now, I feel proud to be a Catholic laywoman. Internally and externally, I am practicing, trying my best to do God’s work in the world.