the chaplain
the chaplain can tell from caller id the call is important, so he picks up. after all, the whole idea behind being on call is to be available to help someone in need.
the nurse tells him about a schizophrenic patient who is having a “crisis.” the young man believes the reason he is hospitalized is because of a “demon.” he is agitated, nauseous and has been throwing up on and off all day.
“can you help?”
“i’ll be right there.”
by the time the call ends the chaplain is nauseous too. this hits too close to home. but this is the job, and it is probably not a coincidence that he—and not his peers—is on duty today.
after hanging up, he quickly checks the patient’s medical file to gather more information. he discovers the man was diagnosed with schizophrenia a few years earlier, is medicated and suffers what appear to be periodic seizures. he was admitted due to syncope and collapse.
theologically speaking the chaplain believes demons are real. but he also knows enough about schizophrenia that demonic delusions are common. while the former cannot be ruled out, his gut tells him it is probably the latter.
the chaplain closes his eyes and sighs. déjà vu washes over him. the waves keep coming and coming, and it does not feel good.
he knows from personal experience the patient cannot be reasoned with. anyone who tries to educate, persuade or convince a schizophrenic that interactions with “demons” are a sign of mental illness is destined to fail. those who try to use logic and common sense will only join their patients in the misery of delusional thinking.
the chaplain also wonders whether the patient is prone to violence. if so, his goal of being the calmest person in the room will be more challenging than usual.
he becomes aware of his heart rate--it seems higher than normal. “yes,” he thinks to himself, “it is definitely beating faster than before.” the chaplain has been anxious before, but never to this extent.
regardless, he must go, and go he will. common sense, duty and an insatiable desire to help others compel him.
now fully equipped with context and bitter memories from the past, the chaplain pulls out his cell phone and opens a bible app to paul’s letter to the ephesians, chapter six. he reads verses 10-18 and then locks the phone with the app still open. now the passage can be easily accessed if—more than likely, when—it is appropriate.
he is now prepared to wage spiritual or psychological war, and perhaps even both.
he silently prays for divine help to fulfill his calling and rises to his feet. he chooses to use the stairs, not the elevator. the chaplain knows this decision is a shallow attempt to avoid the inevitable but does it anyway. this is not merely a pursuit to get his steps in for the day, but an uncontrollable urge to run and hide like the notorious jonah.
but god eventually convinced the prophet to do his will, and the chaplain knows he will no doubt suffer the same fate. when he arrives at the patient’s room, he sanitizes his hands with purell and his mind with more silent prayer.
now—at last—he is ready to enter the lion’s den.
he knocks on the door and calls out to the object of his compassion.
“zach?”
“yeah…that’s me.”
there are two people in the room, but only one is visible, the one in bed one. he is the source of the verbal response. the other is quietly hiding behind a curtain, the only thing separating him from his puking, schizophrenic roommate.
zach is sitting upright in the middle of the bed, shirtless and wearing skin-tight green pajama bottoms. it is clear his hair has not had the pleasure of being brushed or combed for a long period of time—it is the visual definition of “bed head.” he is too heavy to go without a shirt but is obviously not concerned with such things.
his face is welcoming yet distant all at the same time. a gold-colored, kidney-shaped shallow bowl sits on the tray next to his bed anxiously awaiting another deposit.
the man looks familiar, though the two have never met. the chaplain is very uncomfortable, but a conversation must take place.
“hi, i’m chaplain so and so. i wanted to check in and see how you’re doing.”
it will not be helpful to mention the phone conversation with his nurse. nor will it be wise to use the “s” word unless the patient himself brings it up first. the chaplain is determined to say as little as possible and listen as much as it takes.
as it turns out, his patient has no problem with spilling his guts to a total stranger.
“not too good. something is wrong with me, and i don’t know what it is. it’s like i get these thoughts in my head—like a demon—and then i feel sick and drop down to the floor. it feels like a demon is pulling me down and i can’t get up.”
voices. his patient hears voices.
the man’s face appears incapable of showing emotion. his mouth moves, but it is done without a frown or even a hint of discomfort or fear. his eyes are lifeless, like a shark’s. not cold or threatening, just lifeless.
his face is just…neutral.
but the chaplain knows the importance of listening and he has heard what has been said. he knows about the admission diagnosis of syncope, collapsing and the “demon,” so none of it surprises him.
“do you pass out or faint?”
“no. i just can’t get up. that’s why my mom called for the ambulance. i couldn’t get up. i don’t think people believe me when i tell them it’s a demon. i read about somebody getting an exorcism…maybe that’s what i need, i don’t know.”
the chaplain leans in to close the gap between him and his patient. he wants zach to know he has his undivided attention which, of course, he does. job responsibilities have very little to do with such a personal approach: déjà vu, guilt and an ingrained desire to help another person are the primary drivers.
“what did the doctor say?”
“nothing. they can’t find anything wrong with me.”
“they ran tests and didn’t find anything?”
“nothing. i’m not sure they believe me.”
“you mean about the demon?”
“yeah…i don’t know what to do. this has been going on for three years now.”
despite zach’s dire situation, the chaplain is struck by the sound of his voice: it is measured, even and without emotion. even though his words are scarred and dripping with frustration, fatigue and defeat, they are uttered with unworldly calm. even in declaring defeat there is no “oomph.”
mental illness wins. again.
the chaplain is not surprised the doctor has not found a physical reason for his symptoms. nor is he surprised to hear zach suspects no one buys into the whole “demon” theory.
and he certainly is not surprised to find out his patient’s symptoms first started three years ago. is it a coincidence he was first diagnosed with schizophrenia at the exact same time? of course not.
this half-naked young man sitting upright in a hospital bed might be connected to an iv and a monitor, but there is very little doctors can do to help. sure, there are meds, lots of meds. and yes, there is psychotherapy and even extreme measures like electro convulsive therapy (ect). but all are ultimately doomed to fall short of producing any meaningful improvements in the quality of life.
even though not empowered to make a medical diagnosis, the chaplain’s suspicions are proved valid: the simple but harsh reality is zach is lost and always will be. his life—as he once knew it—is gone and there is no going back. not really.
but hospitals are filled with well-educated, compassionate and determined people who do not like to accept defeat. it goes against their dna. so, he is in the right place to get help, such as it is.
as the two sit quietly staring at each other wondering what comes next, a doctor walks briskly into the room. his hands are busy sanitizing one other while his mind is no doubt mulling over what to try next. the physician sees the chaplain and stops, smiles and says, “i’ll come back later when you’re done.”
the doctor leaves as quickly as he enters, and the chaplain silently wonders what the medical professional was going to say.
it might have been, “i’d like to run some more tests.” or maybe it was, “your symptoms may be due to your mental illness, so i’d like to refer you to a psychiatrist.”
then again, maybe, just maybe the doctor is glad to see someone from spiritual services in the room and is secretly thinking, “maybe you can have better luck with him than i can.”
truth is, that is exactly how the chaplain feels.
having lived with a schizophrenic for years, he does have a unique perspective on how to best treat this patient. at least in the short term. zach can benefit from both medical and spiritual interventions, but right now the latter has more value than the former.
if the whole demon thing is true, then only god can succeed where professionally trained humans cannot. of this the chaplain is theologically convinced. but even if a demon is only a manifestation of mental illness (the more likely explanation), then spiritual intervention can help in a psychological sense.
a win-win scenario, regardless of the source of the “demon.”
if zach believes in spiritual bad guys, he probably believes in spiritual good guys too.
enter god.
“if a demon is causing this…”
the words do not come easily for the chaplain. can he really say this as a paid employee of a hospital? is this even ethical? heaven forbid if the patient believes what is about to happen is an exorcism.
the chaplain has never been in a situation like this before and feels as if he is trying to navigate through a mine field. yet, a conversation still needs to take place. help cannot arrive without words.
“if a demon is causing this then the only person who can help is god. you believe in god, right? you’re a christian, right?”
according to his medical chart, he is a “christian.” and the patient himself has used the words “demon” and “exorcism.” yet why does this whole approach feel like a leap of faith?
“yeah, i mean, of course.”
while not the most affirming of responses, it is good enough to proceed with the chosen care plan.
“then you need to know this, zach: god is all powerful and more powerful than anyone and anything, including a demon. and god—who lives inside of you since you believe in jesus—can and will protect you.”
he is no longer just looking at the chaplain; his eye contact is so steady and intense it makes chappy squirm internally. the nauseousness returns. both are in the same boat, although for different reasons.
for good or bad, ethical or unethical, his patient is hanging on every word from this pathetically inadequate representative of the creator of the universe. spiritual interventions can help with spiritual and psychological problems, right?
“i want to share a few bible verses with you from ephesians 6. it’s called the ‘armor of god’ passage.”
the chaplain reaches into his shirt pocket, pulls out a cell phone and begins to read.
“finally, be strong in the lord and in his mighty power. put on the full armor of god, so that you can take your stand against the devil’s schemes. for our struggle is not against flesh and blood, but against the rulers, against the authorities, against the powers of this dark world and against the spiritual forces of evil in the heavenly realms. therefore put on the full armor of god, so that when the day of evil comes, you may be able to stand your ground, and after you have done everything, to stand.”
even though there is more spiritual meat in the passage for the two of them to consume, the chaplain decides to stop reading. he does not want to overwhelm his vulnerable and impressionable patient.
a cynic fondly known by the name of doubt whispers in the chaplain’s ear: “you idiot, for all you know, zach thinks this is some kind of exorcism and you’re father damien from ‘the exorcist.’”
but the chaplain knows better. he is no priest and has no plans to ever utter the words, “the power of christ compels you!” he is just on call at the tail end of a long weekend day shift. and whether it is providence, luck or fate, he is the only staff member armed—and burdened—with personal experience relating to a schizophrenic.
the only words he really wants to utter right now will never see the light of day—they must remain imprisoned inside his churning stomach.
“can somebody please tell me how the hell i can ethically
and compassionately help this poor man?!”
yet the chaplain knows what he does say next is important: he has gone down a narrow path that only leads to one destination. despite being the very words of god, we humans—whether they be zach or the chaplain’s younger brother, ken—will benefit from a visual reinforcement of god’s “armor.”
and what better visual than the one god himself paints in ephesians 6?
“have you ever seen a movie from medieval times? you know, a movie with knights in it?”
zach nods. yes, of course he has seen a knight in armor, shining and otherwise.
“they’re wearing a suit of armor that protects them from head to toe, right? and that’s to protect them in battle, right?”
he nods in agreement and leans in closer to hear the punch line.
“as a christian, you have the armor of god on! just as a knight is protected by his armor, you’re protected by god’s armor!”
zach leans back to take it all in. his face still screams, “flat affect!” but body language tells a different story. something has penetrated his illness’ protective shield.
“if a demon is causing all of this, god can protect you, zach. god loves you and is more powerful than demons!”
the chaplain’s inner critic returns for an encore performance: “who do you think you are, a warmup act for billy graham?”
both he and his patient are hearing voices.
it is a devastating blow to the chaplain’s self-confidence, yet he is able to silently respond with a right snappy, pilate-inspired retort: “i have said what i have said.” while this is no exorcism, it is a well-meaning spiritual rescue attempt.
the man in the bed on the other side of the curtain groans, then grunts. only his feet at the end of the bed are visible. since this is a hospital, it is reasonable to assume the roommate is in pain. but the chaplain’s mind goes in the opposite direction.
he holds his breath and prepares for battle with the man in bed two. it could be spiritual heckling from a god-hating heathen, or perhaps a guilty verdict of heresy in the first degree. either way, he is in danger of being unable to continue the quest to free zach from his “demon.”
does he view the chaplain as a religious nutjob?
is he a messenger of satan sent to way lay him?
is he a medical ethicist critiquing his approach to zach’s condition?
there are lots of internal questions, but no answers. only the other patient’s feet are visible, and the groaning and grunting have stopped.
emboldened by several seconds of silence and no movement, the chaplain turns his head back to check on his patient. what he finds is spiritual gold. the chaplain has seen many people cry over the years, but none so satisfying as this.
while there are no sniffles or tears streaming down the cheeks, the orbicularis oculi muscles surrounding the eye sockets are contracting. it looks like he is squinting. then, miraculously, his eyes become glossy, then moist and then close to overflowing. the tears reach the top of his lower eyelids, but do not make it over the edge.
the symptoms are observed and diagnosed: emotion. controlled, but still emotion. schizophrenic but still human.
no matter what zach’s roommate feels or does not feel, or believes or what does not believe, the chaplain is glad. for both he and his patient. the treatment appears to be working.
“thank you, sir. i feel better.”
“you’re welcome. would you like me to pray for you?”
zach nods, and his lips and chin come ever so close to quivering, but his illness will not allow it.
the chaplain -rises to his feet and steps forward until his knees brush up against the end of the bed.
“do you mind if i hold your hand?”
zach responds by stretching out his right hand to embrace the chaplain’s. if someone walks in and sees what is happening it might appear to be just two men—one young and the other old—shaking hands. but this is much more than that. it is a chaplain offering the only kind of care he is qualified and empowered to provide: spiritual care.
in his prayer he thanks god for loving and protecting zach. and while the treatment plan requires heaping doses of both, he focuses more on the former: for it and it alone is the key to healing. humans—including those who are mentally-ill—need and want to be loved.
protection is great, but to be loved…to die for.
after saying “amen” the chaplain finds his patient’s eyes in the same condition as before: close to flooding over the lower eyelids, but not quite. emotion. controlled, but still emotion. schizophrenic but still human.
“thank you, sir. i feel better.”
whether the “demon” is a spiritual reality or a delusion—god’s armor has helped.
the man in bed two grunts and groans again. the chaplain glances over and sees he is now sitting on the end of the bed. his feet are both firmly planted on the floor, but his knees and upper legs are the only other things that are visible. the rest of the man—his upper body and no doubt disapproving face—is still hidden behind the curtain.
once again, the chaplain silently wonders whether the man is friend or foe. regardless, he appears to be on the verge of offering his opinion on what has just transpired.
he braces for a god-hating tongue lashing or a scathing accusation of unethical behavior, but neither occurs. because of that, he refocuses on his mission of freeing the prisoner still holding his right hand.
the spiritual care plan is nearly complete, but then the chaplain spots a large grey tattoo of an ornamental cross on zach’s right forearm. why he got the tattoo and what it represents to him is unknown, but it is an unexpected opportunity to put an exclamation point on this patient encounter.
the chaplain decides to assume the best: it represents the cross of jesus christ, the beating heart of the christian faith.
“you see that cross?”
zach glances down at the mark on his arm and then back at the stranger still holding his hand. yes, of course he is aware of the cross, but not sure why it is pertinent. his face does not show it, but the aroma of curiosity fills the room.
“every time you feel like a demon is messing with you, i want you to look at that cross and remember what we talked about today. god loves you, and god will protect you.”
“thank you, sir. i will. i feel better.”
his response, as before, is music to the chaplain’s ears.
patient knows god loves him. check.
patient knows god is more powerful than anyone or anything, including “demons.” check.
patient heard the very words of god via scripture and was prayed for. check.
patient has a mental image of a knight wearing armor to remind him of god’s protection. check.
patient can look at the tattoo of a cross on his arm to remind him of all the above. check.
it is now time to say good-bye, the man on the other side of the curtain decides otherwise. he grunts and groans yet again. his feet are still planted firmly on the floor, and his knees well positioned to stand and face the enemy should that be his will.
while the man in bed two may be in pain, the chaplain still has doubts. all he hears in this moment is another unwanted whisper in the ear: “all of this religious mumbo jumbo changes nothing and you know it!”
unfortunately, the chaplain does know it.
zach is lost and always will be because that is what schizophrenia does. it is ruthless and unrelenting. sisyphus has a better chance of rolling a boulder up a hill than this man has in overcoming his mental illness.
but in this moment, the chaplain also knows he has done his best to help another sojourner here on earth in need. in the short term it seems to have helped.
“it was nice meeting you, zach. i’m glad we got a chance to talk.”
“me too. i feel better.”
“i’m glad. let your nurse know if there’s anything else i can do for you.”
as it turns out, there is something more the chaplain can do to help his patient. zach reaches over, picks up his cell phone and says, “do you know of a good bible app?”
“i do…i like the one i use, the youversion bible app. do you have an i-phone or an android?”
“android.”
“then you can go to the google play store and download it if you want.”
the chaplain holds his phone up to show zach what the app looks like, but his mentally ill patient has already found it on the play store. nice: a last-minute and unexpected addition to the care plan.
patient can look up the passage on the “armor of god” anytime he wants. check.
“take care, zach.”
“thank you, sir.”
the chaplain walks out, fulfilled but emotional. he is glad his patient is feeling better and even grateful. but he is also sad at being forced to reflect, however briefly, on bitter memories from the past.
his patient is better—at least for a while—but ken…
the chaplain leaves the room and walks past the front desk. three nurses look up, eager for an update on the floor’s most frustrating and labor-intensive patient, but none is offered. the chaplain keeps his head down and walks briskly toward the sanctuary of the stairwell.
once the door closes behind him, he leans against the wall and cries. unlike his patient, it includes audible whimpers and tears pouring over his lower eyelids.
his patient feels better, but the man’s spiritual physician does not.
the chaplain returns to the office, head down and avoiding eye contact for fear of being outed for the sin of public grieving. his emotions are too raw to be shared with others.
he documents the patient visit in the electronic medical records but does not mention anything about an exorcism. nothing of that sort happened. he mentions the interventions provided and the fact that his patient appeared to be doing better because of them.
as the chaplain drives home, he imagines what he would write if asked to self-assess what happened at the patient visit. the words come easily.
chaplain forced to remember painful memories best left in the past.
specifically, chaplain did not want to resurrect memories of his brother’s diagnosis and obsession with demons. nor did chaplain want to be reminded how he pushed ken out of his life only to eulogize him after years of neglect.
finally, chaplain was not happy to reflect on how he reacted after his brother’s untimely death: pleading with families of newly diagnosed schizophrenics not to give up on their loved ones.
while chaplain believed god used him and his personal life experiences to help his patient, he was left emotionally drained, full of regrets and remorseful.
the trip home goes quickly as his mind plays and replays the patient visit over and over again. he ponders ken’s fate as well as zach’s and tries to convince himself they do not necessarily have to be the same.
“i feel better.”
the chaplain pulls into the driveway and his wife emerges from the front door, eager to greet him after an especially difficult shift. he knows how the evening will go: she will listen attentively, love on him and he will cry some more. then they will eat dinner, watch a movie and go to bed.
if the phone rings, it will not be answered.