Chaplains help patients translate their own experience into personal story.
Over time, I’ve begun to think of my chaplaincy through a metaphor of language: chaplaincy as translation. Can I speak evangelical Christian well enough to achieve genuine or even useful understanding with a patient? Can I listen, translating internally into language that makes more sense to me?
Can I, for example, understand original sin to mean the fundamental, pervasive brokenness that I believe all human beings share—not condemning an innately flawed humanity, but compassionately recognizing that we all struggle with something, we all have cracks somewhere in our minds, hearts, and “souls”? Can I translate a belief in Jesus Christ as a personal savior into a desire to have a model for one’s life, as a yearning for the clarity and help that I look for myself in my spiritual practices? Can I hear the frequent prayer for a miracle as a deep recognition of the seriousness of the situation and of human helplessness in the face of crisis?
My translations are, inevitably, imperfect. Are they enough? I worry about what gets lost in translation.
In addition to the fact that they can help me better connect with my patients, I have personal reasons for trying to learn these other languages. After all, the better we understand other languages, the better we understand our own. Studying a variety of foreign languages over the years has helped me understand my native tongue in a way I never would have without these foreign perspectives. And the reverse is true as well. The more you understand your own language, the more effectively you can translate others. This holds for the metaphorical translation work of chaplaincy as well—after all, the lingua franca of chaplaincy is self-knowledge and awareness, which are then used to help others.
I meet people, to the best of my ability, where they are, listening for their values and beliefs as a way of understanding their pain and suffering and, ideally, of connecting them with their strengths and sources of hope. I cannot understand completely, and so perhaps it is enough just to be a compassionate, nonanxious presence.
Over the years, many patients and families have assumed that I shared their beliefs. I think my skills as a chaplain dovetail with their profound stress to create an effective and comforting illusion of alignment. Despite my years of doing this work, I struggle from time to time because, at a deep level, I don’t believe what many of my patients do. I find some of it ridiculous. Indeed, I find some of it offensive. I try to understand why they believe as they do. I try to understand how these beliefs function in their lives and in their social settings. But still, when I check those beliefs against mine, a gap opens up between us.
Some people might claim that my beliefs are irrelevant, as are perhaps even the beliefs of those I serve as a chaplain. My visits to patients theoretically exist in some kind of neutral supportive space and concern them, not me. Chaplains bracket out their own beliefs to be present to the patient. And I can do that to a large extent—I can simply sit and listen intently, reflecting back their fears and hopes, serving as a mirror in which they can, hopefully, face their worries and see them in the context of their sources of hope and strength.
But as a professor of mine was fond of saying, “There’s nowhere you can stand that isn’t somewhere.” Neutrality is an illusion. I can never be a perfectly clear window; I will always tint what passes through me with my inward colors. I will always hear through the echo chamber of my own attitudes and perspectives. Indeed, one of the first things we are taught is never to say, “I know how you feel.” I don’t know how you feel or how you understand death or God. I don’t know what this particular moment of suffering, which I happen to be present for, means to you in the context of your life and faith.
I reach out across that gap and do three main things. First, I bear witness through unflinching presence. I don’t turn away from your suffering, remorse, guilt, or anger. Second, I ask what this experience means to you. Where does this episode fit in the narrative of your life? Third, I try to help you connect with sources of strength and hope, whatever they may be: organized religion, disorganized religion, hiking, schnauzers, grandkids, whatever. Many people have no one who can effectively do these three things, these acts of human love and compassion. It is hard to witness difficulties and suffering without intervening, trying to solve them, or feeling personally responsible for them. Too often we feel empathy—we feel what the other person feels. But empathy is frequently unhelpful. To be present every day, as I was in the ICU, to the truly horrific and undeserved injuries and illnesses of dozens and dozens of people, children and adults—to hundreds of deaths—requires a careful management of empathy. I bear witness to each crisis, but it isn’t my crisis.
I practice focusing on sustainable compassion over empathy and now teach caregivers to do the same. But family and friends, and even doctors and nurses, often find it difficult to healthily separate themselves from the pain of others. They don’t venture into the wilderness with the patient, because they fear getting lost themselves. Many of those who suffer feel—at a deep, sometimes inchoate level—a sense of abandonment. But the chaplain doesn’t shy away, and the chaplain asks the questions few others want to ask or hear answered. What are you afraid of? How do you feel about dying? What does this disease or death actually mean to you, and how will your life be forever changed by it? And often this is the most real work of translation we get to do as chaplains—ask these compassionate yet firm queries about how the patient’s personal story has changed.
Story is critical to emotional and spiritual health. At the core of this work lies the simple truth that human beings live our lives through narrative. The story that links our past, present, and future is our conception of self. Who are we without this story, these reference points? When trauma scatters the mind and overburdens language, we are left with a gap, a void in that narrative.
We must translate the raw data of experience into coherent elements of story, so that the tale becomes a bridge that enables our minds to pass over that experience, remembering without reliving, without stumbling or falling headlong into dysfunction. Chaplaincy can help with this translation work as well, helping the individual give shape to words that reclaim the gaps. This translation does not occur between patient and chaplain; rather, the chaplain helps the patient translate, and thus better understand, their own experience. My understanding is secondary to my skill at exploring new metaphors and stories with my patient.
Despite my willingness to wander in this desert with my patients, the meaning and context their suffering holds for them are hard for me to access. I don’t believe people suffer as punishment for their sins—or at least not that this suffering is imposed by an external deity. I don’t believe that we go to a paradise or a hell when we die. I don’t believe that intercessory prayer is effective. But many of my patients believe all these things and more. They tell me their answers and I listen, and I hope I understand well enough to help and support them.
Translation is seldom, if ever, a simple replacement of one word or concept by another. There is always nuance, and skillful translation requires an idiomatic command of both tongues. I’m not sure I will ever be fluent in evangelical or Catholic. But I work on it, slowly improving my ear, gradually getting better at seeing the nuances in the semiprivate individual languages of prayer, suffering, and meaning. No truly common language may exist for the singular experience of profound suffering and loss.
Translation occurs not just between chaplains and patients; chaplains also help patients translate within themselves. I help patients translate what might have seemed like babble into comprehensible utterances, deciphering experiences into meaningful stories. Since I have little commitment to a particular spiritual/linguistic frame, I can sometimes help patients find their way into a different metaphorical structure. Indeed, sometimes my job is to challenge a language that has run out of words, become too constrictive, too restrictive to let people fully express themselves.
Mistranslation is always a risk—and I may never realize my errors. I watch, of course, for the other cues: a smile, the deep sigh of released tension, the hand outstretched in appreciation of my presence. I wonder about what gaps in understanding remain.
And so I listen as my patients speak their hopes and fears, their angers and joys into the space between us, translating their theological views into ones that I can understand, access, manipulate. I can then re-present these back to the patient, filtered through my perspective, a perspective tempered by emotional and temporal distance, and hopefully communicating my presence, compassion, courage, and desire to help. I muddle along, mostly being understood, sometimes not—but I try, as best I can, to communicate authentically.
What I hope gets found in translation is what I believe to be ultimately true—that we may never really understand each other, but it is critically important to try. The presence, even in and among the mistranslations, is more important than complete understanding. In the end, I believe this presence—this full human honoring without assumptions, this appreciation without complete understanding, but full of love and compassion—is what gets found in translation.
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The Rev. Nathan Mesnikoff is director of spiritual care at Memorial Hospital: University of Colorado Health.
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