Spirituality and Compassion in Healthcare

Speech announcement

Here is the text of my prepared presentation given in Grenoble on Spirituality and Compassion in Healthcare

“Good evening, thank you all for your curiosity about my thoughts on caring for those among us, our families, and friends, who suffer from illness. I would like to express my gratitude to Hocine and others for making the arrangements which make my presence here possible. At this time, I would like to introduce to you the two women who will make it possible for us to understand each other, Béatrice and Alice. As I was preparing this presentation I told them they were more important than I am today. It is these two women you will be paying the most attention to. There are many others living in various other locations in Europe who have also made it possible for me to be here. I am deeply indebted to many people.

I appreciate the invitation and opportunity to speak about spirituality, compassion, and providing care and comfort for those suffering with illnesses, disease, ageing, and those who are transitioning from life to death. Also I would like to point out that it is not only those with the illness who struggle and need compassion it is also those who care for and support the individuals and loved ones during these times of crisis. It is my hope that we can contemplate how we as individuals and as societies might be able to use not just the resources of institutions such as hospitals, and nursing homes, but also the resources we have as individuals.

I come to you today first and foremost as a human. In many ways, you and I are very much alike. We share concerns universally with all other humans. We have concerns for safety, shelter, food, and health. We know these as universal human concerns. As a human these are my basic concerns. I am also a Buddhist priest practicing in the Mahayana tradition and following the teachings presented in the Lotus Sutra and understood by a 13th century reform Tendai priest, Nichiren. I am also a chaplain working at several hospitals in Charlotte, North Carolina. And I am many other things as well. However, today I will be speaking with my Chaplain and Buddhist voices. In other words, I will be speaking from my heart, and from my passions in life.

As a chaplain I have been trained to provide spiritual comfort to people in various stages of crisis caused by any number of life events. While the training would technically qualify me to work in a variety of settings from industry, natural disaster relief, prisons, hospitals, police, military, well not me now I’m too old for the military, and many other areas where chaplains frequently are found. For myself I have specialized and limited myself to hospital work primarily and some prison work. I have spent a considerable amount of time with cardiac/heart patients and most of that was in an ICU setting. I have also spent a lot of time working with people who struggle with addictions. And presently I am working primarily with geriatric, 65 and older, patients.

A chaplain is different from a pastor or priest who goes to visit someone, perhaps a parishioner, in the hospital. Chaplains are trained to provided spiritual and moral support that is not denominationally specific. So I can provide support for Christians, and in fact I do so on a daily basis since most people in my part of the country are Christian. I am unable to provide specific denominational instruction such as a Baptist or Catholic may wish. As an employee of the hospital and a member of the multidisciplinary medical team caring for patients I make notes in patient charts concerning my visits with patients. I also participate in meetings with doctors and nurses where discussions are held concerning diagnosis, treatment, outcomes and goals for patient care. I often not only provide comfort for the patient and family, I also provide comfort and care for doctors, nurses, food service people, and environmental services. In fact, I am there to provide spiritual and moral support for virtually everyone.

Do chaplains pray or offer prayer? Yes, we can, we don’t always. Our objective is not to simply pray and leave. We are there to help individuals connect with their own spiritual resources or develop them. To help a person understand their life and the transition that they are facing. To help someone move from hopeless to hopeful. There are many things the chaplain does and most of them are not praying, though we each certainly offer our personal prayers for those we visit. This I hope helps you to create an understanding that chaplain work or spiritual support is not simply about or confined to religion.

This is my first time to visit Grenoble, and I would hope it is not my last. The capital of the French Alps has a long history going back over 2000 years. It was under the rule of St. Hugh that a rebuilding of the bridge over the Isère River and construction of two hospitals occurred. One of the hospitals was a regular hospital; the other was for lepers. I lived in Hawaii for 10 years and on clear days you could see the island of Molokai where the famous leper colony of Kalaupapa is located.

In 1979 the first of my friends died from a mystery illness that was slowly killing others. Society and science ignored it for several years. Doctors and scientists refused to examine and research these increasing number of deaths until the number of deaths had grown to staggering figures. Later it was finally given an official name SIDA/AIDS for short. That was the official name, the unofficial name was the gay plague or the gay leprosy, and many other cruel names. Over the years I have witnessed and been present to many, so many, way too many deaths.

It was during this time I became active in caring for dying and sick people. People infected with SIDA/AIDS became the modern lepers. In the early days, there were no hospitals where they could go. Doctors turned away these sick and dying people. Families abandoned their sons, and even friends would shun friends. Yes, even gay people treated each other as lepers. We humans are capable of accomplishing some remarkably wonderful things, and we can also be cruel and lacking compassion.

At first I would attend to close friends. As time went on I would get referrals because people knew I was one of those who would visit and tend to the dying. I was one of many attending the dying, yet we were not enough. The needs and the deaths were staggering. The devastation was particularly bad in California and New York. I am incapable of telling you the number of young men, boys really, I witnessed dying in the years since 1979. In fact just this year a friend died from HIV/AIDS whom I had been helping for 4 years. I could go into much more detail on this. For today however let me simply say this was the crucible in which my passion for caring for the sick and dying was born.

One of many lesson I learned was the ability to be present with, and to be a witness to the suffering of other people even when I could not fix the problem. I learned that my willingness to be present, to not run, to not complain, to not let my inability to fix things get in the way of being both physically and spiritually present and connected to another human being is priceless to the person receiving. I also learned that making meaning out of a life, or the story of one’s life, is something each of us has control over and it is up to us to determine what our lives will mean.

Witness and meaning making or life story, I wish for you to hold onto those for a moment. Hold those thoughts if you please while I talk about spirituality and compassion.

There is a difference between religion and spirituality. The two ideas or concepts are independent from each other. During the French War of Religions the people and the city of Grenoble suffered greatly. I am well aware that something that is presented as a good thing for people frequently causes great harm. Religions while making various promises to assist human kind, to solve the problems of human suffering, have in fact been responsible for terrible tragedies. And the tradition of suffering in the name of religion has again visited France with the terrorist attacks in Paris last month done in the name of religion. Today what I would like you to consider is not religion but spirituality. Two very different concepts, even though they can both inform each other. It is possible to have one or the other without both. And for a brief moment I will include scientific knowledge.

On the notion of scientific knowledge I celebrate Grenoble for its reputation as a premier center for scientific research. There is a very large 2000+ bed teaching hospital located in Grenoble. The hospital where I have worked the most and received much of my training is also a teaching hospital and our entire hospital system is the second largest in the US, with the Veterans Administration Hospitals being the largest. When science presents us with a better understanding of the workings of things thereby allowing all humans to prosper and improve we find some remarkable advances in health, security, and community. The same things can be found when religion is at its best. When either become dogma, restricting the freedom to choose, restricting the freedom to compare, the freedom to ignore, then neither is beneficial and instead become a yoke.

Every morning the sun rises above the horizon and appears in the sky for us to benefit from. That fact is beyond our control. Science provides us with a lot of factual information about the sun. Science has enabled us to gain a different understanding from what religion provided for many centuries. It is no longer a chariot, nor is it revolving around the earth, it is not a deity to worship, no longer is the earth flat, and no longer are we the center of the universe, and further the universe is much bigger than we imagined.

Science and religion or religious institutions are incapable of making the sun or causing it to do anything other than what it has been doing since the sun became the sun. In that regard science and religion can only offer explanations. I also believe that neither science nor religion make the sunrise beautiful. Religion and science can provide a foundation for a feeling of awe or wonder. They both can provide a foundation for gratitude to grow, for appreciation to blossom. Neither however has the ability to make you feel either happiness for a sunrise or sadness for a sunset. Your feelings then come from a different place.

I suggest that it might be spirituality that enables you to be both who you are as a unique person, and to be aware that you are part of a larger existence. Larger existence here does not imply a god, but rather recognizes that there are things beyond our control, beyond our counting, beyond personal experiences to prove or disprove, and still not be afraid, and not feel powerless. Spirituality says, that is beautiful and whether I understand or not the beauty remains.

Spirituality can be associated with religion, but it does not need to be.

Spirituality requires primarily only one thing. That one thing is you. Spirituality is not found in rules, or regulations, dogma or doctrine. Spirituality can exist in the presence of those things but does not require them. Spirituality is one potential unifying factor we have with all other humans. You are French, and may not be Buddhist. We are possibly many different religions and some with no religion. Some are educated with special degrees and some may have never had the chance to go to college or finish school. There are many factors that would divide us. Yet tomorrow morning when the sun rises we are all equally likely, if we wake up in time, to look upon the emerging light as the sky shifts from night to light, and perhaps say “tres magnificent”. The only thing required is you and your witness of the event.

Another point here is the beauty only exists when you see and experience it, you need to be witness to see beauty. I can describe what I saw but I can not give you the actual thing, nor is it possible to allow you to experience what I experienced. Beauty only requires our witness, that is all.

Religion is a human construction, a tool that can assist us in understanding our relationship with the mystery and the single event that is inescapable to all humans; that is death. Science is a human construction that can assist in managing and understanding all that surrounds us and sustains our existence. What a religion teaches and what science explains may contribute to our awe or it can contribute to our fear. What I am personally concerned with is not what religion a person ascribes to or doesn’t. I am not concerned with what science discovers. What I am most concerned with is how those beliefs and discoveries will contribute to the happiness of all humans. I am concerned with how we can satisfy the universal human needs I identified at the beginning. In other words, what is the spirit or energy or drive of a religion or discovery? Is the spirit towards wholeness or brokenness?

It is the spirit or spiritual that transcends human constructions such as religion and religious dogma and doctrine. And so in that way we all participate in spirituality, even if we are not aware of it. Just as the sun is beautiful only because you perceive it that way, so too spirituality can move and inform us if we choose to allow it. Either situation only requires your witness, your presence, and are beyond your creation.

Taking you back to my accounting of providing care to SIDA/AIDS patients I ended with two lessons; witness and meaning. Just now I ended with spirituality and beauty requiring only for us to witness. Witnessing, simply being present are so important and yet are often ignored. To sit with someone in the pain of their life, to listen to their experience, to simply nod one’s head, or hold a hand are some of the most valuable and comforting things we as humans can do for each other when science is unable to do more or religion has not provided the miracle.

To witness is sometimes difficult for us because we feel a need to fix things. When we are with someone who is experiencing a life changing event and there is nothing we can do to make it better or to make it go away causes us to be uncomfortable and perhaps even try to avoid the situation. So at a time when someone needs us the most we may not be present. It isn’t that we don’t wish to be present, it is simply that our personal experience of discomfort becomes so powerful that we fail to connect with the person we are caring for. Doctors and nurses, as well as anyone who cares for someone in a long term situation, frequently will succumb to this and we refer it to compassion fatigue. In other words a person gets tired of witnessing and being unable to solve or fix the problem.

Early on in this presentation I left you holding onto the idea of witness and meaning making or life story. I then moved to illustrating a difference between religion and science and spirituality. Now I would like to talk about meaning making or personal story.

A personal story is not simply a collection of historical events that occur during a lifetime. Meaning making is about how those events have shaped who you are today or who you will choose to be in the future. Life events and our relation to and understanding of can change over the course of a lifetime, and indeed they should. Frequently in our lives something traumatic may occur. Perhaps there is no clear reason why such a thing occurred, yet it does. And perhaps it is so traumatic it becomes unforgettable, and there is no reason why we should forget something. The question then becomes how do we proceed with the rest of our lives.

For the young boys who became infected with the AIDS virus these questions of why me and what now were thrust on them, and at such young ages. It is the same with our young soldiers and military personal all over the world on all sides of conflict. Why me and what now?

To the young boy who has not much longer than two or three weeks left to live it is challenging to even care much about what now. There is not much beyond now. Yet many I witnessed and other who I knew of choose to life with purpose in those final few days. I knew a boy who wanted to learn to play a trumpet and so for roughly two weeks he took up and I will declare, he mastered the trumpet. The beauty of his sour off notes was without dispute the sound of a courageous soul. Rather than die as an AIDS victim it was important for him to die a trumpet player. Others had used drugs and choose to give up drugs for the rest of their lives. It doesn’t matter that time was short. You could almost excuse someone for taking drugs when they have nothing left to live for and frequently the pain was excruciating. Yet for them it was important to not die a drug addict.

We each are not merely a collection of historical events that occur along a time line. We have stories, we have meaning, and it is only the individual who can define their own lives. How we ourselves understand our own lives, how we understand what made us into who we are, what events in our lives were critical to our present self. I witnessed in the stories of the young men the ability to define one’s own life and not let other define it for you.

In summary today let me see if I can tie this all together. I come today as a person of religion and someone who believes in certain specific doctrine found in the Lotus Sutra. I understand that my religion does not connect us together very well. In fact, religions frequently do not connect people they tend to divide us. I believe we can rise above this by connecting with our spirituality our awareness however we define it that we are part of something much bigger than ourselves.

I believe that when we reach out with spirit we can touch lives in ways that would not otherwise be possible. Spirituality does not require me to ask what religion you belong to. Spirituality allows me to declare the sunrise was beautiful this morning, without asking you who you think created it. Spirituality allows me to sit with you and witness your pain, and not run from or condemn because you belong to a different religion. Compassion is supported in spirituality. Religions do not always support compassion. A willingness to be present with and not run from others when they are suffering. Compassion helps me understand that I can not fix all things and I am not expected too.

I have no illusions that some great thing will result from my speaking today and your presence. If I am allowed to be honest about what I hope will result from today is rather small. I hope that perhaps each of you will look around you with a clear understanding that we all are in this boat of life together. We each have a choice in how we will live our lives and how we will support the lives of others. We each have sufferings, the first of the Four Noble Truths, found in Buddhism. It is undeniable that we each will face death, our own certainly as well as the deaths of friends and relatives. How do we deal with these events and how we help other deal are important. I hope that we can face the challenges ahead with compassion and a fearless determination to live a truly spiritual life.

In closing let me again thank you all for letting me speak today and for listening and considering what I have shared. I do hope I may someday return to Grenoble and perhaps we can spend some time together. I actually prefer speaking with people one to one and so after I am finished perhaps I can meet some of you personally. Again thank you and as you return home please do so carefully.

With Gassho,
Ryusho”

During the delivery of this presentation the contents were changed occasionally.

With Gassho,
Ryusho
Posted from my TARDIS
(It’s smaller on the outside)
Allons-y

About Ryusho 龍昇

Nichiren Shu Buddhist priest. My home temple is Myosho-ji, Wonderful Voice Temple, in Charlotte, NC. You may visit the temple’s web page by going to http://www.myoshoji.org. I am also training at Carolinas Medical Center as a Chaplain intern. It is my hope that I eventually become a Board Certified Chaplain. Currently I am also taking healing touch classes leading to become a certified Healing Touch Practitioner. I do volunteer work with the Regional AIDS Interfaith Network (you may learn more about them by following the link) caring for individuals who are HIV+ or who have AIDS/SIDA.

Comments are closed.