Nosheen Rafique drapes a crocheted blue-and-yellow prayer shawl over Linda Nicholson’s frail form.
Nicholson smiles -- these are her favorite colors.
With one hand she clutches the shawl, her fingers entwining the soft stitches. Her other hand reaches for Rafique.
Nurses, administrators and Austine Duru, head of pastoral care at CHI St. Elizabeth, gather around the hospital bed. Nicholson’s husband, Ken, sits beside his wife of 55 years. He bows his head, so she won’t see his tears.
Loving God,
We have gathered here to share our prayers for Linda.
May each stitch of this shawl carry a blessing along with our love and care as it enfolds her.
May this shawl be a source of hope, warmth and comfort in good times as well as difficult ones.
People are also reading…
Rafique has recited this prayer hundreds of times with cancer patients and families over the last 13 years.
Sometimes the outlook is good, the prayers full of hope.
This is not one of those times.
Nicholson is going home to Clatonia. It is there she plans to die with Ken and her beloved pups at her side.
She’s lost her battle with ovarian cancer.
Cancer is very difficult.
It’s very sad, very challenging, said Rafique, chaplain for the cancer care unit at CHI St. Elizabeth.
The wife of a Methodist minister, Rafique says pastoral care, regardless of your religion or the higher power you do -- or don’t -- believe in, can calm the soul, warm the spirit and bring a sense of comfort medicine alone cannot provide.
“My time is of presence, listening and prayer,†says the soft-spoken Rafique.
“I let the patient take the lead: ‘You tell me when, and I will pray for you.’ Prayer is not pushed.â€
***
For much of history, humans have depended upon their chaplain advisers.
Religious leaders, monarchs, noblemen, warriors, doctors and laymen have sought advice, guidance and moral direction from chaplains for 3,000 years.
Although chaplaincy has its roots in Christianity, most religions, including Judaism, Buddhism and Islam, have chaplain-equivalents.
Today, chaplains can be found in most hospitals, nursing homes and medical establishments. They are stationed at schools and universities. They are at the ready of police, fire and other emergency services.
Religious faith is the foundation for their work, but pastoral care is at its heart, said Jerome Barry, director of pastoral care for Bryan Medical Center.
“People in times of stress and trauma -- good or bad -- begin to question the meaning and purpose. They question life-and-death issues and ponder things we don’t typically ponder,†Barry said. “The pastoral care chaplain is trained to walk in the room and not advocate for a particular faith or religion, but to meet the person where their needs are at.â€
Those needs vary vastly, particularly among those patients with mental health issues or substance-abuse problems.
Chaplains provide spiritual care, not in the sense of God and church, but in the deep-seated meaning of life and what-is-my-purpose sort of way.
“Spirit is a natural dimension of every person,†wrote Larry VandeCreek and Laurel Burton in a 2001 consensus paper for the Journal of Pastoral Care.
“Spirituality … describes an awareness of relationships with all creation, an appreciation of presence and a purpose that includes a sense of meaning,†they wrote in a joint statement representing the positions of 10,000 chaplains in North America."
“Spirituality demonstrates that persons are not merely physical bodies that require mechanical care. Persons find that their spirituality helps them maintain health, cope with illnesses, traumas, losses, and life transitions by integrating body, mind and spirit. When facing a crisis, persons often turn to their spirituality as a means of coping.
“Many believe in its capacity to aid in the recovery from disease, and 82 percent of Americans believe in the healing power of personal prayer, using it or other spiritual practices during illness.â€
To ignore the spiritual needs of people leaves a vast hole in comprehensive care, said Duru, St. Elizabeth’s director of pastoral care.
“I do believe caring for people is not just a mindless act. It should include body and spirit, psychological and social in such a way we can provide all-around healing,†he said.
And even in cases like Linda Nicholson’s where the outcome is not what the patient wants, spiritual care can provide comfort, compassion and peace at a time of great distress and fear.
“Our role is to add spiritual connection to the healing process," Duru said. "We believe (healing) does not happen in isolation.â€
Because St. Elizabeth is a faith-based hospital, all staff from medical professionals to housekeeping are encouraged to integrate their faith into everyday activities.
“We do not believe you need to keep your faith at home when you come to work,†Duru said.
It’s a concept Bryan Medical Center is beginning to embrace. Following St. Elizabeth’s lead, Barry said Bryan chaplains are working with staff to help them get through traumatic events.
***
For 20 years, Janna Gubser was an employee at St. Elizabeth.
Then, she became a patient.
Suddenly, the manager of the hospital’s critical care unit was the one needing answers and strength.
In 2005, at the age of 44, Gubser was diagnosed with breast cancer. Rafique was there for her.
“Pastoral care within St. Elizabeth always has been viewed strongly as a major facet of getting through what you are going through,†Gubser said,
Gubser was cancer-free for the nine years that followed.
Then in June 2014, a routine follow-up exam revealed the cancer had returned.
“It just rocks your world,†Gubser said.
This time around the treatment plan is rigorous -- four months of weekly chemotherapy treatments, a radical double mastectomy, and now, radiation.
“Cancer is ghostly. It is like an alien,†she said.
It would be easy to have a pity party, Gubser admits. But it wouldn’t do her any good.
“You have to dig down deep to get through this to stay positive and reach out,†she said.
She reached out to Rafique.
“I knew if I needed her, she would be there,†Gubser said.
As would her former colleagues, offering spiritual support as well as medical treatment.
“It feels like there are wings around you, and you are being coddled at a time you need it most,†she said.
***
On Dec. 19, 2014, Rafique crossed paths with Kimbra Underdahl.
Diagnosed with breast cancer this past July, Underdahl came to St. Elizabeth for a lumpectomy -- surgery to remove the cancerous mass.
“She came into my room, and she changed my life,†the 58-year-old Lincoln woman said of Rafique.
“I feel like she will be on this journey with me for the rest of my life.â€
That first visit began with introductory small talk, eventually getting around to talking about God, Jesus and faith.
“She (Rafique) stayed for 40 minutes. I was no longer nervous. I had no fear,†Underdahl said. “I felt like I had known her for years.â€
When Underdahl was discharged, Rafique promised to be there when Underdahl returned for her first day of radiation.
She kept that promise. And in fact, Rafique has been there before -- and after -- every radiation treatment since, Underdahl said.
Rafique’s presence has helped in two ways.
“I knew she was someone with deep faith, and I would be comfortable. She’s a powerful influence, and she puts me at ease for the next part of my journey,†Underdahl said.
Learning you have cancer is terrifying, Underdahl said. It’s the kind of diagnosis that makes you want your mom -- regardless of your age.
But Underdahl’s mother had died three years earlier -- that absence made the diagnosis and treatment seem even more grueling, Underdahl said.
Then in walked Rafique.
“It’s like my mom sent Nosheen,†Underdahl said. “Her sweet smile, hugs and assurance is like a gift from my mother. She cares about me. She just knows what to do and when to do it at the right time. God provides that.
“I’m so glad God put her in my path.â€
Rafique smiled after hearing that.
“This is who I am,†Rafique said of her chaplaincy. “Of course it is a paid job, but I don’t call it my job. This is who I am. I love doing what I do. It is very rewarding.â€