The patient is very, very weak. So weak she cannot even talk, and remains motionless in her special chair, hooked up to drips and other devices. But she can smile.
“It’s good to see that smile. What a beautiful smile,” says the chaplain who is on his regular visit. “We communicate a lot here, don’t we? Are you feeling a bit better?” The patient nods, slowly.
The chaplain is on one of his regular walkabouts at Harefield. This is the transplant unit where some of the very sickest, most vulnerable patients are looked after. Some are literally hovering between life and death. This patient had a heart transplant less than two months ago, but is now making slow, slow progress.
The chaplain has visited her every day on his rounds and says: “We look forward to the day you leave and say goodbye, which will just be amazing.” He moves on. So much of the job is just about this – talking, spending time, covering as much of the hospital as possible, keeping spirits up.
Not surprisingly, the chaplain seems to know everyone – staff, patients, visitors. We meet one regular visiting patient who lives some 10 hours away and is here once again for a check up after having a lung transplant four years ago.
“We became your social life and you became ours,” she says, referring to the pandemic when the chaplain was one of the only people able to visit, to maintain links to the outside world, to fulfil the human need for connection.
It is a lifeline, a calling, that this chaplain has been fulfilling for a relatively short five-and-a-half years (Harefield and the Royal Brompton have famously high retention rates). Prior to that he was a parish vicar in London, where he said the 72 hours “in a quiet week” took their toll.
Harefield itself reached out when his wife, also a regular patient, said one day: “You’ll never guess who’s looking for a chaplain…” Now he cannot think of a better job. “I can do more of the things I am vaguely competent at doing, instead of being asked to do something about the heating in the toilets.”
With his colleagues, a small team at Royal Brompton and Harefield, linked to the larger chaplaincy team at Guy’s and St Thomas’, he makes himself available “to anybody, for any reason, for whatever they need.”
If that sounds broad, it is meant to be. Each of the hospital sites across the Trust has its own particular blend of multi-faith needs, ranging from Muslim, Jewish, Roman Catholic, Hindu and Sikh to Eastern Orthodox and Coptic. Before now, the chaplain has had to find someone able to speak Amharic, the principal semitic language in Ethiopia.
He is also careful not to be too ‘preachy’. “There is a difference between religious care – which of course some people want – and spiritual care.”
Nor is it only about the patients. “The team took it quite hard,” says a sister during our visit. “We had a young transplant patient in their twenties who had complications and passed away. It was just good for our team to be able to talk to the chaplain.”
His colleague tells the same story. During a quiet moment in the staff room, he tells me the chaplains speak to anyone, about anything. “I often talk to staff who are facing their own difficulties, whether it is to do with mental health, or domestic challenges, or bereavement. Sometimes it is just about being there to support them. It’s about listening.”
I ask how they cope themselves, absorbing all this stress, listening to people’s grief, taking on their problems. The chaplain smiles. “It can be hard. You can see some people nearly die, several times, then get better, and then pass away. That can be very upsetting. But I’m just grateful Harefield sees the need for us.”
As we continue on our rounds, it’s clear everyone is gearing up for Christmas. Decorations – suitably vetted by the infection control team – are appearing. Christmas gifts are being delivered. This brings its own challenges, of course. Patients who won’t be home for the holidays. Families torn apart by illness, devastated by grief.
So it is even more meaningful when the chaplain tries to ease the pain. “People used to come round and sing carols but of course since the pandemic, we’ve not been able to do that, so I now bring round my iPad and play carols on that.” One patient with severe dementia was completely unable to communicate when, suddenly, on hearing Christmas carols, she started to sing. “Her relatives were crying their eyes out…”
I’m now getting a better feel for what the chaplaincy does, and just how valuable it is. But it is another patient who sums it up, stuck in the dreadful limbo-land of waiting, and waiting, and waiting, for the right transplant to come along.
“They give you time. And patience. All the staff here are wonderful – the doctors, the nurses, but they just don’t have time. The chaplain gives you his time…it’s a support network,” he says.
It’s a simple thing but as Christmas approaches, the message from the chaplaincy seems all the more important – it’s about being there for those in need. They need your support, your time, and your patience.