Candles burn, a fountain trickles, and soft, gentle melodies soothe careworn spirits at noon every Tuesday on the seventh floor of Fairview-University Medical Center.
One person or a dozen people might attend the 15-minute service Chaplain Karen Watrud Mackey leads in a quiet room. Opened three months ago, The Meditation Place is a non-denominational respite within the immediacy and technical nature of the medical atmosphere.
Prayers are offered aloud or silently while visitors join together in a circle of cushioned chairs. Midday light shines through stained glass windows decorated with themes of creation and life — rain, earth, sea and sky. The time is dedicated for reflection, healing and hope, and Watrud Mackey patiently supports those who wrestle with unanswered questions and fears regarding illness or death.
Providing prayers and meditation on these Tuesday afternoons is just one of Watrud Mackey’s duties as a staff member of Fairview’s Spiritual Health Services. As one of the University’s five chaplains, she serves both the medical and surgical intensive care units, the heart and lung transplant teams, and works on a rotating on-call basis.
Her job is evaluating patients’ spiritual needs and support systems while they prepare for medical procedures. Listening, holding a hand or giving a hug are all part of her daily routine, as well as counseling and performing spiritual assessments.
Although chaplains are required to have endorsement of their own religion, they do not work by denomination. Watrud Mackey is an ordained minister of the United Church of Christ, but does not perform specific Christian rituals or prayers unless a patient requests them.
“All of us have an inner spirit,” she said. “What nurtures a person’s spirit is different. For some, religious beliefs and practices nurture that inner spirit; for others that isn’t the case.”
Relationships are what define spirituality in Watrud Mackey’s work. She helps people explore their relationships with themselves, other people, creation, and their perception of a creator or God.
When a person undergoes an evaluation for a heart or lung transplant, Watrud Mackey performs a spiritual assessment. She asks the patient to name the most important resource in his or her life that helps give it meaning.
Termed as “the hope model,” these resources can include people, beliefs and values, personal qualities, present activities and future plans. When the person has identified five areas of strength, she uses them as a framework for what can give that patient hope to persevere through his or her illness.
Although the University has always employed chaplains in the hospital, recent years have celebrated a trend in the growth of spiritual care and alternative medicine. The Center for Spirituality and Healing was formed in 1995 in the University Hospital and Clinic as an outlet for continuing education for health care professionals.
When Fairview Health System merged with the hospital last year, the center was retained by the University as part of the Academic Health Center. It now offers courses for medical students and health care professionals and sponsors research methods of alternative medical practices rooted in cultural or spiritual beliefs.
Mary Jo Kreitzer, director of complementary care and The Center for Spirituality and Healing, said there is a growing interest in alternative and spiritual care methods among medical institutions. Last year, the center launched a research initiative for integrating these methods into medical school programs.
Besides investigating such therapies as acupuncture, healing touch or ancient Chinese medicinal rituals, the center also focuses on increased use of chaplains as part of a health care team.
“I think that the interest reflects a growing consciousness on the part of people in our society, that they believe the care of the whole person is important,” Kreitzer said. “They recognize the importance of the mind and the spirit component of healing.”
She cited growing bodies of research and a higher level of interest on the part of consumers and health care professionals as reasons for the boost in alternative care.
“I think more and more people are recognizing there’s a big difference between healing and curing,” she said. “Healing is much more about wholeness. In some ways, maybe you could say it’s a search for meaning.” Chaplains can bring that meaning at the beginning of a medical procedure or diagnosis, rather than being called in when someone is dying.
Using chaplains as part of a health care team can help patients develop coping skills for the life changes their illness might provoke.
Kreitzer stressed that using spiritual healing practices is not an opportunity for a health care professional or chaplain to impose their own beliefs on patients. Instead, doctors and chaplains focus on learning about a patient’s beliefs and how to support them.
Although this approach can be used by health care professionals, a chaplain’s work might fill a void doctors and nurses cannot.
“People want to be heard, to feel cared for and for matters to be kept confidential — and that’s universal,” said Gregory A. Plotnikoff, assistant professor of internal medicine and pediatrics and medical director of the Center for Spirituality and Healing.
He also practices in the Community University Health Care Center, which offers primary medical care to inner city residents. Plotnikoff, who previously worked as a chaplain, said managed care has changed clinical practices toward more task-oriented, assembly-line medicine, where productivity is the goal.
“Our attention is drawn away from caring and healing,” he said.
This provides a difficult situation for health care professionals when faced with patient questions about treatment or mortality.
“Spirituality is not about handing out the answers,” Plotnikoff said. “It’s about the questions.”
For example, patients might ask a doctor if they will die horrible deaths. One thing that might instantly run through a physician’s mind, said Plotnikoff, are medical conditions that would fall under a ‘horrible’ category and try to answer the patient’s question. But Plotnikoff explained that patients might not want a medical answer.
Instead, patients are asking a spiritual question that stems from personal definitions of a horrible death, which might include dying alone or too young. A chaplain can help address issues which present themselves in such spiritual questions.
Watrud Mackey deals with similar questions every day.
On Mondays, she attends a lung transplant support group where patients discuss their anxieties about waiting for donors. Transplant recipients also attend the group to share their experiences with others.
“I think a lot of what happens in that support group is spiritual nurturing,” she said.
In a visit with Kay Hoeppner, who recently underwent a heart transplant, Watrud Mackey sat with Hoeppner and her husband Robert as they recounted Kay’s last month in the hospital.
One memory in particular was the ceremony Watrud Mackey performed when the Hoeppners wished to renew their wedding vows. Kay Hoeppner’s wedding rings, which were removed for the first time during her surgery, were put back on and the Hoeppner’s were able to celebrate their new life. The Meditation Place played host to the service, for which Watrud Mackey printed programs and brought flowers.
“The emotions with this are really hard to deal with, as much as the medication,” Hoeppner said. “I know I can always talk to Reverend Karen.”
Hoeppner discussed her feelings of guilt that someone had to die for her to receive a heart, and Watrud Mackey assured her many transplant patients deal with the same feelings. At the end of the visit, she joined hands with the Hoeppners and prayed with them.
When she isn’t conducting her assessments or intensive care unit rounds, Watrud Mackey will check out family waiting rooms. She especially likes to spend time with visitors who are alone.
“When somebody’s here without support, that’s a time when I become more involved,” she said.
If a patient is dying, Watrud Mackey keeps in close contact with the physicians and the family. When death occurs, she immediately stays with the family and helps them organize funeral arrangements.
She said often when there is no medical cure for an illness, there can still be a great deal of healing on a spiritual level.
“The inner spirit is a very powerful thing,” she said.