Rev. John Hester leaned over Cheryl Deraiche's hospital bed in Stanford Hospital and delivered Holy Communion last week. Deraiche, who is receiving medical treatment for leukemia, received the holy wafer on her tongue and accepted Hester's blessing. During her first hospital stay in October, Deraiche received Communion six days a week.
"I was a single mom working full time. My whole life changed overnight. Having the spiritual support really helped me get through that. It has helped me bridge those two lives," she said.
Each day chaplains and volunteers from Spiritual Care Services at Stanford Hospital and Clinics visit hundreds of patients to deliver a kind of healing that medical interventions, surgeries and treatments cannot make whole. Spiritual care offers respite from pain and suffering and offers a balm to anxious souls, patients and practitioners said.
Sometimes help comes in the form of prayer; at other times it involves administering the sacraments. It can be about listening or just being present. Or volunteers or clergy might bring an item the sick person has wanted, such as clothing or a blanket, said Hester, the Spiritual Care associate director and volunteer-program coordinator.
More than once, Hester has used creativity and daring to help ease suffering, he said.
On a recent Tuesday morning, he quietly recalled a particularly inventive way he brought comfort to a dying woman and her husband. The patient had already had two liver transplants and stayed at Stanford for nine months, he said.
Hester had looked down at the woman in the bed.
"She looked like a refugee. She was gaunt, yellow," Hester recalled.
Her husband traveled faithfully from Reno to visit his wife, driving down and back in his truck so he could be by her bedside. Hester noticed that his arms were covered in open wounds and sores, the effects of stress, a doctor had said.
Hester sought a way to help the couple. He learned that a member of their family had been left behind in Reno: The couple's dog had been boarded in a kennel for those nine long months.
"Let's bring the dog down," Hester said, noting that it took two baths to get the animal clean.
But there was a wrinkle the chaplain hadn't considered.
"I didn't know the make or model of the dog," he said.
The animal was large -- a 70-pound pit bull and black lab mixture. Hester needed to get the dog into the hospital without causing a staff uproar. He arranged for the engineering department to deliver a dolly. They put the large cage containing the dog on top, and they concealed him with a covering, he said.
Then he gave a command.
"You've got to go like hell," he said, as the animal was wheeled down to the intensive-care unit.
Released into the patient's room, the dog sniffed all around. When he spied his owner, he sat yelping by the side of her bed, Hester said. Towels were laid out, and they lifted him on top and set him beside the gravely ill woman. The big animal went down on all fours and began licking her hand, Hester recalled. His voice broke as he recounted what happened next.
"She put an arm around him and said, 'Oh, darling. You remember me.'"
The hospital staff allowed the dog to remain until the woman died, Hester said.
"There was no prayer, no blessing," he said, noting that, sometimes, spiritual ministry is not what the patient desires.
For the dying woman that day, the gift of love from her animal companion was the greatest comfort of all.
"You realize there isn't anything greater than that," he said.
Spiritual care at Stanford is an interfaith ministry. Five chaplains are assisted by 230 volunteers. They span faiths from Buddhism and Islam to Hinduism, Judaism, Catholicism and Mormonism, said Rev. C. George Fitzgerald, director of spiritual-care services.
The program maintains a roster of community faith leaders who supply services and minister to patients to whom the core staff do not. When a Russian Orthodox patient needed religious counseling, for example, Spiritual Care went to the community to bring in clergy, Rev. Susan Scott said.
In addition to administering spiritual rites, chaplains and volunteers also help patients emotionally, identifying the issues that add to their distress, for example.
What do they miss from home? How are they changing life priorities, given their illness? Naming fears and issues helps make them tangible, as if they could reach out and touch them, said Rabbi Lori Klein, chaplain to the oncology unit.
"Someone might take comfort from saying they are scared or grieving," Klein said.
Once they have named their concern chaplains such as Klein can help the patient develop ways to cope, she said.
Prayer, if so desired, might come well after a relationship with the patient is formed, she added.
"There's a woman I've been visiting with for months. Yesterday was the first time she said she wanted to pray with me," she said.
Deraiche sat upright in her bed in the hospital's cancer ward. A soft cotton hat covered the effects of her treatments. She had arrived only 24 hours earlier for her second hospital stay at Stanford. Diagnosed with leukemia on Oct. 11, she was admitted to the hospital just one day later for her first stay, she said.
Receiving Holy Communion and prayer have helped Deraiche through her sometimes difficult treatments, she said.
She recalled one time that almost seemed divinely sent.
"I was right about to have a procedure that is painful. It was hard to get it started, and the nurse left to check on something. Right at that moment, in walked a volunteer with Holy Communion," she said. The sacred rite was perfectly timed.
"I was pretty scared. It was just what I needed," she said.
Volunteers Jeanne Placone and Suzanne Sweeney deliver Holy Communion to patients such as Deraiche. On a recent Tuesday, the women met with 20 patients each. Both had joined the Spiritual Care group after being its recipients, they said.
Placone's mother, who died 32 years ago, was ministered to by Hester. Placone was so impressed by the care her mother received that she considered becoming a volunteer. But it took six years before she could face returning to the hospital, she said.
"I got to Stanford Shopping Center, and that's as close as I got," she said. But now, "It is totally a part of my life. It's a gift to be able to come."
But it hasn't been easy. At times early on, Placone felt overwhelmed by what she saw, she said.
"So many times I would go in a room, and it touched me so much that I had to go stand outside against the wall. It was hard to know what to do. I would say, 'Oh God, please help me,'" she recalled.
But in all of the years she has visited patients, only one person was bitter, she said. The resilience, love and joy she sees in the sick have been extraordinary.
Sometimes she will see something she never expected, she said.
One or two Christmases ago a young man with terminal cancer lay in a hospital bed surrounded by family and friends. Despite the young age at which his life was about to end, he wasn't sad or angry about all of the things he wouldn't get to do, she said. Instead, he was excited and joyful that he was still there to celebrate one last Christmas.
Placone said giving Holy Communion has a profound effect on patients.
"They close their eyes, and you see the peace come over the person," she said.
Sweeney has volunteered for four years. After visiting her mother in the hospital, she saw an ad in the hospital bulletin for volunteers and signed up for a training program.
"It's been a wonderful experience," she said.
One of her greatest joys is simply being present. Many patients have very few visitors; some rooms are empty, she said.
Oncology patients are sometimes the most profoundly lonely. Some patients are kept in isolation because they have compromised immune systems. Day after day, all they see are people dressed in masks and gowns, she said.
"You are one of the few people who is not a nurse or doctor that come to see them," she said.
Sweeney said visiting desperately ill people allows her to connect with the real person that others usually don't see.
"They are in a very tough spot. There are none of the trappings of life. No one talks about their successes or what they did for a living," she said.
Volunteers go through intensive training. They learn communication skills, prayers for the faith in which they minister, and infection control in hospital rooms. They receive background checks. Volunteers are screened to winnow out evangelists bent on conversion, Fitzgerald said.
The orientation takes place on one Saturday. A second training session involves going out on the hospital floor three times with different mentors to observe various styles of ministry, Placone said.
Hester instructs volunteers not to be patronizing.
"Don't come in and call me 'honey' and 'dear,'" he recalled a patient once said.
Placone said volunteers are strangers entering a stranger's room, and not everyone has religious faith.
"The most important person in the room is the patient. A lot of patients say, 'I'm not interested.' I respect that," she said.
The volunteers let patients know they also offer services that aren't strictly faith-oriented, such as a listening ear when the patient needs emotional support. Or the volunteer might get the person a book to read or help contact a family member.
"It is a rarity for someone to say, 'No. I don't want to see you. Go away.' They say, 'You know, you really made my day,'" Sweeney said.
Sadness and helplessness are familiar feelings that spiritual-care volunteers and chaplains experience, they said. Privacy laws prohibit them from talking about the patients with family or friends.
"Sometimes we're haunted by the things we see patients go through. We go home and we think about them. I've prayed for them every night. I can't tell my husband about them. I would not want anyone else to be burdened. I pray because that helps me," Sweeney said.
Chaplains and volunteers do check in with each other for emotional support. At this time of year, Spiritual Care also holds a meeting to help health care workers deal with "holiday syndrome," Fitzgerald said.
"There is this expectation that everyone may be joyful. (But) a patient might die around the holidays. Particularly with health care workers, they get close to patients. There may be an employee whose son has died or someone on staff has been in an accident. It wipes out the whole department," he said.
The chaplains hold "Schwartz Rounds" -- opportunities for health workers to receive emotional support from the spiritual advisers. Scott said one Stanford unit was recently modified to take on more patients who need end-of-life care. The nurse manager asked the chaplains to come to the unit to help staff adjust to the emotional burdens. The visits are informal and sometimes take the form of a drop-in tea, she said.
The rounds are named after the late Boston health care attorney Ken Schwartz. During his nine-month hospital stay for cancer treatment, Schwartz saw the need for a compassionate-care program that benefited patients and health workers. Days before his death in 1995, he started The Schwartz Center for Compassionate Healthcare, according to the nonprofit organization's website.
Klein said the oncology units have gatherings during which staff share memories and lessons they have learned from patients. She has learned to take life one day at a time.
"I might say that something is too big of a chunk. To help patients get through bad times, I might help them break things down to hours or minutes. I use that in my own life. I might say ... 'I'm having a bad morning; I'll see if the afternoon is different,'" she said.
Scott is the decedent-care chaplain and attends to the needs of grieving families after patients have died. She said her job involves helping people find a place of strength.
"As hospital chaplains, we can't go with them when they leave," she said.
Sometimes that strength comes in unexpected forms. When Scott went to a devastated 21-year-old man whose mother had just died, she could see that words would not help him, she recalled. So she asked if she could get him a cup of coffee.
What he really wanted was a mocha, he said.
"Do you want it with whipped cream?" Scott asked.
The young man savored that moment of respite from grief, she said.
But there are times when all Scott can do is be present.
"As a student chaplain, I was with a family where there was a very sudden death, and the wife and daughters collapsed. For several hours they didn't talk. They just looked at their laps. I felt so badly. There was nothing I could do for them," she recalled.
So she just sat with the family for hours.
At a gathering of families sometime later, Scott said she recognized the mother. She wanted to tell the woman that she had been there that night, but Scott didn't know if the woman would remember.
The mother approached her instead.
"She walked up and said, 'Oh, Susan! I remember you were here with us.' That was a lesson," she said.