DAY BY DAY, AROUND THE CLOCK, ambulances come and go from the UAB medical center, and life-saving helicopters land and lift off from a rooftop pad.

None of this activity is visible from the office of Clinical Pastoral Education (CPE), located on the first floor of UAB Hospital. The people who work there are interns training to be professional chaplains in hospitals and other health-care settings. And they are ready to respond when the patients in those ambulances and helicopters—or their family members—request spiritual care to supplement their physical treatment.

Comfort in a Crisis

CPE staff and interns come from a variety of religious backgrounds, but program director Malcolm Marler, D.Min., says that theological details tend to become an afterthought in times of crisis.

“There’s something about suffering that makes people put aside dogma,” he says. “One challenge for us is that often people’s religious beliefs aren’t working for them in a crisis situation—no matter how hard they pray, they can’t change things. For other people, their faith is a tremendous comfort that helps them deal with a host of problems. So we try to meet people wherever they are spiritually.”

Chaplains have long been a familiar sight in church-based hospitals, but in recent years, the concept of pastoral care has spread to secular medical centers such as UAB and even to Fortune 500 companies that make on-site counseling available to their employees. UAB relaunched its CPE program, which has a year-long curriculum, in the fall of 2009; each CPE class has room for six students.

Not everyone who’s in a ministry is cut out for clinical pastoral education, Marler says. “One of the defining factors,” he explains, “is whether a person, regardless of his or her own faith background, is receptive to learning new things. The key is to be open to learning from the people you counsel, rather than coming in with a set of answers you have to convince others of.

"The people we see in the hospital come from all faiths and traditions, and from no faith. We have to use their language instead of our own—to become sort of multilingual in a spiritual sense. To walk beside people where they already are.”

Leaps of Faith

CPE teacher and program supervisor Carol Green says her own career started on a different path. She worked as an intensive care nurse in Montgomery and as a missionary intensive-care nurse in Gaza, the largest city in the Palestinian territories, before enrolling in seminary.

When she was in Montgomery, “I’d often see visits from ministers whose behavior was inappropriate, and who created more difficulties than they solved,” Green recalls. “And many of the students I’d known in seminary said they dreaded hospital visits worst of all, because they didn’t know what to say.

“A hospital chaplain in Montgomery had been instrumental in my education and career, and I began thinking that this was a field I’d like to go into.”

Marler worked for 14 years in a local church before spending another 15 years ministering to AIDS patients at UAB’s 1917 Clinic. “Being director of pastoral care is not a position I sought,” he says. “It took a significant leap of faith. But I’m really excited about how it’s worked out, because the position allows me to use all of my past experiences in one setting. It’s like weaving together the different panels of a quilt until you finally see a pattern.”

Call to Celebrate

Not surprisingly, dealing with days full of patient crises can be detrimental to one’s own emotional health. Green has incorporated into the curriculum a specific module on “self-care for the minister,” and students are encouraged to do ongoing personal therapy as well.

“Fortunately, we don’t get just bad news,” says student Sandy Herren. “Sometimes we get the call to celebrate with people. That’s exciting, especially when they’ve been here a while and we’ve developed a relationship with them and lived some of that suffering with them. It doesn’t happen every day, but it’s great when it comes.”

Green also makes clear to her classes that pastoral care is no avenue for evangelizing, ever. “What we look for in students is the capacity for compassion and empathy,” she says. “To be able to get outside themselves and truly attend to the needs of another person, while satisfying their own theological beliefs separately. We work in a pretty pluralistic, multifaceted environment. But unwanted proselytizing is not appropriate even in a sectarian hospital.”

Never Alone

Green says she’s found that the program’s inaugural class “brings a lot of energy toward being with other people in crisis, and they also are motivated to gain self-knowledge. They’ve quickly found a place for themselves in this institution—with staff, patients, and families—and are already having an impact, both emotionally and spiritually.”

It also helps, according to Green, that no one in the group is a beginner. “They’re all graduate students with seminary experience. They’re in residency to specialize in becoming chaplains most of the time, but they’re also able to bring their experiences as pastors to the job.”

Marler, reflecting on his own career, says his approach has changed considerably since he began providing clinical pastoral care. “I used to walk into a hospital room silently praying, ‘God, help me say the right words in this situation,’ which is not really a bad prayer. But now, what I ask is, ‘Help me to be present for them, and to learn what I need to learn.’ There’s a degree of healing in that.

"In a crisis, all the religious details and traditions tend to get pushed over and replaced by the question, ‘Am I alone in this? Or does God, or whoever—somebody—care?’ And they find they’re not alone."

More Information

UAB Pastoral Care