E72: The Spiritual Domain of Stress

Katie: Welcome to the "7 Domains of Women's Health." We're in the end of our episode on stress, and so today we're talking about some challenging times in our lives.

I've been thinking about that we're coming up on five years now that we've been living with COVID. I lost my father early in the pandemic. He caught COVID that first July 4th wave and was gone three weeks later. And it came at a time when we were completely shut down. I was seeing patients virtually and teaching my classes virtually, and I wasn't able to be with him when he passed away. I mean, we did his funeral on Zoom.

These anniversaries come around, and it reminds me of that and thinking about just how will you manage through those challenging times and really awful stresses.

For me, it's a little bit about paying attention to the tiny things, the color of leaves or the color of the sky or the expanse of the stars in the sky. But certain things remind me. I think it's just the calendar turning over, and it's like, "Wow, five years ago." And looking back on that time of being stressed and being alone, that was really difficult.

How about you? How are you doing?

Kirtly: My life is complicated. As you know, I'm caregivers for little, tiny people and for grown-up people. When I think about particularly how I deal with my spiritual life . . . because when I am stressed, I do try to find a space, and sometimes it's outside in my garden. I'll mention later on in the podcast about what I consider as consecrated spaces, which are often religious spaces, even though I'm not a member of that church. It could be a synagogue. It could be a cathedral that I just walk into. And not infrequently in my 40 years living and working in hospitals is in a hospital chapel.

But I look for a consecrated space which is quiet so I can hear my own voice. I've always said when you're working and living in complex spaces like a hospital or a clinic, and you're an educator, you rarely get a chance to listen to your own heartbeat.

And I believe that if I just give myself a little time in a quiet space . . . Maybe it's the bathtub, which it was all the years when I was raising a kid, because he couldn't come into the bathtub. That bathtub was my time. But listen to my own heartbeat. And when that happens, I hear my own inner spiritual voice telling me that it's going to be okay and that it'll be calm.

So during the COVID epidemic, or during my 40 years in a busy hospital, finding a quiet space where I can listen to my own heartbeat. I do have pulsatile tinnitus, so I can always hear my heart beat in my ears. For any of you who have tinnitus that pulses, you always hear your own heartbeat.

But having that opportunity just to listen to my own best voice, I look for that. And it usually requires a quiet space, and it has to be a special quiet space. The hospital chapels have been often, because that's where I spent 80 hours a week for 40 years of my life.

Katie: Well, that is a terrific introduction because we're going to be talking to one of the chaplains from the University of Utah today. With us today on the "7 Domains" podcast is Reverend David Wolfer. He is a board-certified chaplain here at the University of Utah. And we are really grateful to have the chance to talk to you and learn about the services that you provide and a little bit about you.

So maybe you could start with telling us a little bit about your reactions to all of our stress and any advice you have to offer these two stressed-out ladies.

Kirtly: And this isn't a 50-minute hour, and we're not giving you $500, which is what you do every day, is give free stress care. Go for it, David.

Rev. Wolfer: Well, thank you guys so much for having me. It was interesting to hear you talking about COVID just now. I think that COVID pulled more people into chaplaincy and pushed more people out of chaplaincy than any pandemic or medical condition that I have ever experienced in my entire life.

When I was training during COVID, it was so difficult. You couldn't sometimes put on the equipment fast enough to get into a room before someone had passed away. You couldn't get the family into the room fast enough before the person had passed away when they had to put on the full suits and the mask and the eye protection.

And I watched many times as the hospital said, "No. One person," "No. Two people, and the chaplain, and that's it." No one else could go in there, and you're trying to hurry as they've transitioned the patient to comfort care.

It really is wonderful to be, as you said, away from that time and to be in a better place. But the amount of stress that caused for hospital workers and care staff and people involved in it . . .

My dad passed away in the middle of COVID, and only my mom could be there with him at the bedside because they would only allow one person in. And once she was in, she couldn't leave, basically. She was it. She was the only person that could go in there and be with him. The rest of us had to say goodbye to him via FaceTime or the phone.

And that was so difficult to journey through that. It made me want to be a chaplain even more, honestly, because I was like, "This is something I would like to help other people with." But it is really difficult.

And I still think that mental health deteriorated more during that time for so many people than it did during any other time, at least in my lifetime, that I've experienced.

But on a positive note, in regards to the stress, also I feel like a lot of people learned how to channel stress and places to go where they could be free and at peace and the right people to talk to.

I feel like, in a strange way, it limited our friend circles, our coworker circles, and yet the people that we made sure to hang on to were the ones that were closest with us and the ones that could deal with the difficult conversations that we were having and provided the most to us.

I feel like it made people appreciate nature and want to be out more in nature and just sit outside. As you were talking about, in the bathtub. Just that place where it's just you and there doesn't have to be anyone else. You can just be by yourself with your own thoughts.

And yet, unlike with COVID where no one else could be there, you can get up and move and still go and be with someone and spend time and hold space with them.

It's such a unique time and experience, and it really changed, I feel like, the ways that hospitals, chaplaincy, and stress in general worked.

Kirtly: I really like that phrase, David, "hold space with them." That's a lovely phrase. When you sit with someone, maybe you talk, or maybe you don't. Maybe you just hold hands. I don't know as chaplains whether you can hold hands. But as a physician, I often held the hand of a patient who was in distress. But that business of holding space with someone is a phrase . . . I'm going to hold onto that phrase. It's a lovely one.

Rev. Wolfer: Touch is so important, I feel, as part of chaplaincy. I always ask, "Is it okay if I give you a hug? Is it okay if I hold your hand?" Words and touch, I feel like, are just so important.

And when someone has lost a loved one, I have experienced such a joy to have someone actually offer just to give them a hug, the release of the emotions and grief that come with that. Just that simple arm around the shoulder, holding the patient's hand, putting your hand on their head, it's such a wonderful thing. It's what we call in chaplaincy "ministry of presence." And I think that touch is a very important part of that.

We really just want to provide a helping, supportive hand and provide care to people no matter where they are in life and no matter what they're dealing with. Sometimes really just to be able to sit and talk and listen with someone without having a person that is on the clinical side that has an agenda. We have no agenda. We don't go into a room expecting to try and have an outcome. We just go in there and work with what the patient or staff member provides us and just journey with them through the situation that they're dealing with.

Katie: That brings me to the thing I'm hoping you can tell us a little bit about today, is how do you think a spiritual practice of any sort helps people manage stress, especially the stress of facing a healthcare crisis?

Rev. Wolfer: This is what I found during my about four and a half, five years as a chaplain. You have really great nurses and doctors who provide the physical care part of stress management, the pain relief, the difficulties of treatment schedules, and working with patients on a specific basis to find out what on the physical side they really need to have support in.

But on the emotional, mental, and spiritual side, there sometimes can be a real lack of support. And sometimes it's interesting, the emotional, mental, and spiritual side have a more profound effect on a person's health than even the physical side, the medicine that they're provided with. And that's a very important thing.

But I found it interesting how often direct conversation with someone expressing their deepest fears, anxieties, or joys can turn a treatment session or can turn a patient's entire stay in a hospital around.

Katie: I sometimes wonder what do you think is harder, to be the person who's in the hospital bed or the people who are around that person giving them care?

Rev. Wolfer: Probably both, in some cases. It really depends on the patient's situation and what they're going through. Sometimes, especially if it's a long-term care session, it can be far more difficult for the patient. And yet if it's a person coming in who's there for one day and then passes away, it can be more difficult on the staff. It is such a case-by-case basis when it comes to that.

Katie: I sometimes feel, and this is my own particular bias coming out here, but women are often the caregivers for their spouse or their children. And that stress of trying to hold everything together is a lot for the person. Not the healthcare providers at the bedside, but the family care providers at the bedside.

Rev. Wolfer: It really is true. And that sense of caregiving that I feel that women often provide for everyone in their circle in their life, it really shows itself in the healthcare setting.

And the majority of workers who deal with patients in a healthcare setting are women. And so there's a lot of burden that is taken in there, and it's a very, very specific point of just coming and going in terms of how the stress is dealt with it.

I'd just sort of throw something out there as well. Prior to being here, I had worked with only two female chaplains. So out of about the 12, 13 chaplains that I had worked with prior to coming here, I'd only worked with 2. When I came here, the entire chaplaincy corps was women. And so we have six chaplains, and the rest of them are women.

So that really gave me a unique perspective into how that affects female chaplains and female staff and patients. That has really, I feel, been a blessing having come to a place like that.

Katie: So do you have some suggestions for us or tips or tricks for managing stress in this case that you'd like to share with our listeners?

Rev. Wolfer: That can be one of the most difficult things, I think, in this world. Unfortunately, this world can be really difficult at times, and a lot of that is taken in, especially in a hospital setting, on the people that provide care. If you have nothing left to pour into someone, if you have nothing left to give, if your cup is dry, there is nothing you can provide. And the only place that it hurts is you if you have nothing to give.

There's a lot of compassion fatigue and fatigue in general for those who do that in this field, as I'm sure that you have probably found out on. I mean, that's true for all fields, not just in hospital settings, but there is a lot of stress here.

One of the things that I've found in terms of helping with stress is just processing what you have encountered with friends and family and coworkers. We're bound by HIPAA, so I can't go home and say, "Well, John Smith, who lives in this place, dealt specifically with this."

But I can take the general summary of what happened and just process it with others in my life and to talk through and walk through those situations, to feel the unity with others, the sadness, the anger, the joy, to cry with another person who has experienced something that you have in a similar situation. That really helps in terms of taking the stress meter down, if you will.

Katie: That is so important. And given the work that you're doing, I'm glad you have a safe place for you to process this too, because it sounds like you're sharing a lot of burdens with people. And I appreciate so much more learning about you and what you do here.

I had a good friend who was a chaplain at St. Mark's Hospital, which I think has a different name now. I used to see him running. We were running in the same path, and he said he considered running to be part of his spiritual practice.

Rev. Wolfer: It's really true, having any sort of physical activity. In recent years, since I became a chaplain, I've picked up doing art, drawing. I've picked up biking, going outside. Love the e-bike that I was able to get when I first moved here. So just doing those things that allow you to take your mind off of things.

I know a lot of people that go and golf. I've discovered golf as well. Something else to focus on, to allow those emotions to kind of slowly flush, that stress to slowly flush out from your body. Really helpful to be able to do that on a daily basis.

Katie: It's definitely life-saving for me giving yourself permission to still do something that's fun. When you're going through a tough time, it's easy to eliminate all the fun from your life.

Kirtly: Thinking about the 40 years of my life that I spent, or 50 years almost in hospitals, and how the chapel . . . And all the hospitals in which I've worked have a chapel. If during the incredibly stressful times that I experienced both as a medical student and then as a resident and then as an attending, and that's the person where the buck stops, it's that ability to go into what I consider a consecrated space.

I don't have any ties to any religious tradition, but the chapels in all the hospitals in which I've worked have been peaceful, quiet, sanctified spaces where I could actually try to listen to my own inner voice.

There is so much going on even when I was upset, but the outside upset and the inside upset . . . The fact that inside our own hospital is this quiet space, and you're actually speaking from that right now, David. You're speaking inside our own quiet, beautiful, peaceful chapel.

So I agree, going outside. But when you're in the hospital and the stresses are bringing you down, either as a patient or as a visitor or as a staff person, whoever you might be, there is a quiet space. And it's sometimes filled with other people, or it's filled with maybe a religious gathering, but having that space available inside the hospital is a treasure to me.

Rev. Wolfer: It really is. And when I was first looking at whether or not to come and join the University of Utah Medical Center, I watched a video online of the spiritual care department, and I learned that not only had they rebuilt the chapel here in the last two years, but they had added what we call a reflection room, which is a soundproofed room where you can just go and sit, and the lights are dimmed, and just gather yourself and your thoughts and work through the stresses of the day.

We've put little prayer cards in there and little sacred blessings that people can look at and write. People can write their own prayers, if they wish, and put them in there. Every day, we take them prayers that people have written, and we say a blessing or a prayer over them, or we send our thoughts and hopes to them.

Those places are so precious. As you said, like a consecrated, sacred space. And no matter what religion you're a part of, no matter what spiritual tradition you're a part of, we all have a spirituality inside of us. That's my own personal belief. And as a chaplain, I don't view myself specifically as only for one. I think we all view ourselves as interfaith chaplains, and our goal is to provide support to anyone at anywhere, at any time.

Katie: That is such a lovely service. Can anybody go into the chapel space at any time? Do you have to be a patient or a customer here? If you just happen to be walking through the hospital for an appointment with your dermatologist, can you go visit the chapel?

Rev. Wolfer: You are more than welcome to come in. We were recently able to get the space open from 6:00 to 9:00, I believe. But yeah, anyone is welcome to come in. And we always tell our staff that they're always welcome to come in. People could stop by the office, which we have right next to it, and ask us about it, and we're happy to come and walk them through the area and sit with them or not sit with them. But yeah, you're always welcome to come in.

Katie: I am just really pleased to know about it and know this is available for me not just as a patient, but as a healthcare provider here in the system. So this has been really valuable. Thank you.

Rev. Wolfer: It's my pleasure. You're quite welcome.

One of the things about stress, especially in this hospital, and hospitals in general, is that there's a sense of aloneness. There's a sense of not having someone there. There is always someone there with you in the hospital. There's always someone there to provide support. And we are there for that and to help with stress. Never feel like you're alone anywhere in this hospital or on this campus. There is always someone that will come and provide support.

Katie: Thank you so much, Chaplain David. I really appreciate your time and your wisdom. As we wrap up the 7 Domains of Stress, we want to thank you for listening.

If for some reason this is your first episode of this series, make sure you go back and check out the other six domains of stress. I think throughout this series we've been able to provide a lot of advice about how to manage stress, and a little bit of what we were talking about in this episode of just a place where you talk about the fact that it happens and share some of those things.

The burden shared is a burden halved. And in spite of the fact that it's been a difficult topic to talk about, I think I've found it stress-relieving. So I hope you'll go back and listen to the other domains.

You can find the "7 Domains of Women's Health," all of the episodes, wherever you get your podcasts, or at womens7.com.

And because this is the last of our series on stress, we're going to end with the traditional haiku.

Kirtly: Yes, I'm going to take us out with the haiku of the 7 Domains of Stress. And here it comes.

We are so stressed out.
Be still and listen within
for your kind, calm voice.

Thanks for joining us, and hopefully you'll join us again on some of our other 7 Domains. I hope you all feel a little less stressed today.