Hospital Chaplains Step Up to Fill Gap in End-of-life Care

Seigon Glassing looks like a doctor. He’s wearing black scrubs and sturdy sneakers, and a plastic name tag is clipped onto his front pocket. But if you take a peek inside the medical bag slung over his shoulder, you won’t find a stethoscope or a thermometer.

((Sound of singing bell))

Let thoughts come… let them go…

You might find a Buddhist singing bowl.

Oh I’m hungry… Go back to the bell… Oh I’m bored… come back to the bell…

Glassing is a Zen Buddhist monk and a palliative care chaplain at New-York Presbyterian Columbia Medical Center. He works with patients—many of them of them seniors—who have chronic illnesses. They’re not at the hospital to be cured. They’re there to manage pain, seek support, and find ways of improving their quality of life. And that’s where the singing bowl comes in.

You walk into any ICU unit and there’s constant noise. The lights are constantly on. Very little windows. So it’s a very disorienting experience. If I can create a space— a healing space—in that moment, wherever we are, that can be a very healing experience.

Glassing calls this the “woo woo” part of his work. The Buddhist Monk stuff. And that’s what comes to mind for most people when they think about chaplains—the religious side.

People think like, “oh boy, the chaplain’s here. I didn’t ask for a chaplain! I wonder who sent the chaplain in? And I’m wondering what that means. Like am I dying??”

In fact, you don’t have to be dying to see a chaplain. You don’t even have to be religious. Glassing says a good chaplain doesn’t come to your bedside to talk about their faith. They’re there to listen, which is something most doctors… aren’t great at.

Nick Teodoro is a fourth year medical student. School taught him to listen for symptoms and irregular vital signs. But everything else just kind of… gets shut out.

You kind of get in these modes where it’s like, you know, the question is to ask, you know that the answers you’re listening for. I can hear what they’re saying. Like I can hear what they really want to tell me and I’m avoiding it.

But Teodoro got a taste of palliative care and what he calls “open listening” when he was randomly assigned to shadow Seigon Glassing a couple of years ago. It felt different from everything else he’d experienced in medical school, and it challenged how he thought about care.

What is curing in the end? I… you know… I don’t know. I don’t know.

Teodoro is excited about geriatric medicine and how to better care for elderly patients. But not excited enough. Next month, he’s beginning his residency as an OBGYN.

The number of geriatricians in the U.S. has been steadily falling since 1992. And the American Geriatrics Society says New York has only about half as many geriatricians as it needs to care for its aging population. Evelyn Granieri, who runs Columbia’s division of geriatric medicine and aging, says that’s because working with older patients just doesn’t appeal to a lot of young doctors.

They want to cure illnesses or fix things in a surgical sort of way. But the truth of the matter is as we’re evolving as a society, we’re having more and more chronic diseases which are not curable.

And that’s what palliative care chaplains are all about. Making people comfortable.

((sound: “gorilla noises”))

Seigon Glassing is standing in the middle of a circle of physiotherapy residents, teaching them how to lead a moving meditation. They’re not behaving like buttoned-up and dignified doctors. They follow Glassing’s lead, thumping their chests, knocking on their shins and stretching their fingertips up towards the ceiling. You can feel the tension in the room start to melt away. The whirring machines in the background feel more distant. The residents are laughing.

The medical, you know focuses, as it should, on curative—curing. Making one better. But for us, I think we’re making one whole and that’s the work in progress.

While geriatricians and palliative care doctors catch up, Glassing and his colleagues will hold down the fort.

Sarah Wyman, Columbia Radio News.

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