Chaplain Bruce D. Feldstein, M.D., is the founder and director of The Jewish Chaplaincy and an Adjunct Clinical Professor at Stanford University School of Medicine in the Division of General Medical Disciplines. After specializing in emergency medicine for 19 years, an injury led him to a deeper sense of his life's work as a chaplain. BeWell spoke with Chaplain Feldstein to learn how his background and training, together with several unique experiences, led him to where he is today: the place where modern medicine and spiritual comfort and healing intersect.
Why did you become a Chaplain after 19 years as an emergency physician?
When I could no longer practice emergency medicine, I never could have guessed I would become a chaplain. As an ER doc, I was often incapable of comforting a family after giving them the news that a family member had died. I would be so overcome with emotion in the face of a family’s grief and would have to excuse myself as quickly as possible. Despite this, after a series of experiences I found myself called to provide spiritual care. I have navigated the journey from action-oriented emergency physician to reflective chaplain. I have had to shift my focus from ‘‘curing’’ or ‘‘fixing’’ to bringing comfort and healing, to becoming someone capable of being fully present, bringing all of myself to the bedside: body, intellect, heart, and soul, as well as my training and life experience.
Did you have a defining moment?
The patient, Mrs. Martinez (not her real name), was an 86-year-old Hispanic woman with a history of colon cancer and recurrent nausea, vomiting, and dehydration. She was rehydrated and about to be discharged. Her head CT scan, to rule out increased intracranial pressure, showed multiple metastases to the brain. Because I just met her and her oncologist knew her very well, I planned to let him tell her the news. When I entered her room, however, she asked me a question I could not ignore. ‘‘Doctor, what was the result of my brain test?’’ I sat down and told her as gently as possible: ‘‘Mrs. Martinez, the cancer has spread to your brain.’’ She turned pale, looked away, and said it was a death sentence. I always felt there was something I could say to provide comfort, but what? I tried to reassure her that her oncologist was very experienced and would help her, but it did not faze her. Then I noticed she was wearing a cross and recalled a story Rachel Naomi Remen, M.D., told of a doctor who prayed with a patient. I knew what I had to do, although I had never done this before. ‘‘Mrs. Martinez, are you a prayerful person?’’ I asked. She nodded. ‘‘Would you like to have a prayer together?’’ ‘‘Yes,’’ she said. I took her hand and waited for her to begin. There was silence; I sensed she was waiting for me. ‘‘O God, you who are the great healer,’’ I began, improvising some words. To my utter surprise, she repeated them after me. Then she recited the Lord’s Prayer, which I remembered from working in a Catholic hospital years before. I joined as best as I could. She concluded with a prayer in Spanish, and then looked up directly into my eyes. The color had fully returned to her face; tears ran down her cheek. ‘‘Thank you, doctor,’’ she said, with a depth of gratitude I had never experienced before. The moment brought healing for each of us. I felt profoundly privileged, indeed blessed. I had the distinct impression I was bridging two worlds: the world of science and technology on one side, the world of the sacred on the other.
Why is it important to recognize spirituality as a part of the human experience?
To not address the fact that we are spiritual beings is to overlook an essential part of ourselves. It would be like taking care of the body, but not of the leg ... or showing a picture of the Mona Lisa but not showing her hair. As Teilhard de Jardin, philosopher and Jesuit priest, so eloquently said, “We are not human beings on a spiritual journey. We are spiritual beings on a human journey."
Explain the relationship between faith and healing?
Faith is our orientation toward the future. Faith includes hope, purpose, trust and our sense of connectedness and the basic goodness in life. Religious faith includes our ability to forgive ourselves and forgive each other in front of God.
We often think of healing in medical terms. But healing is more than fixing or curing. People who are dying can still experience healing. There are terminal conditions that can’t be reversed or fixed, but a broken relationship can be mended. There is healing in moving from brokenness toward wholeness, toward acceptance. There is healing in recognizing there is a part of each one of us that is pure and good. Within each of us, there is a human longing for meaningful connection. We help alleviate suffering when we create the conditions for connection with each other and what we hold sacred.
Rachel Naomi Remen put it best when she said, “We can offer healing with our humanity that we can’t fix with our science.”
What is biopsychosocial-spiritual care?
Biopsychosocial-spiritual care is a model of care that addresses the totality of the patient's relational existence — physical, psychological, social and spiritual. We all know, innately, that there is a kind of healing not found in an I.V. or prescription bottle or at the end of a scalpel. This dimension of healing is largely missing from modern medicine. And because it is, we, patients and health care professionals suffer far more than we should.
How can you do the work you do?
For any of us who encounter and respond to suffering, the work is challenging, soul stretching, and sometimes emotionally hard to bear. Yet, this work can also be immensely gratifying in a sustaining way. As Rabbi Amy Eilberg so eloquently writes:
‘‘We walk amid a great deal of sadness, grief, and fear. We regularly encounter the face of injustice and we frequently find ourselves in the midst of trauma and conflict. It is indeed a heavy burden to carry. This demands a great deal of us. It calls on the best of our capacity for compassion. It requires us to be courageous and wise, generous and unwavering. It requires a complex dance of giving and limit setting, of opening the heart and of clear boundaries. We regularly come face-to-face with our own mortality...
Nevertheless, this work also gives us great gifts. We witness much holiness and beauty. We have the privilege of being invited into the most sacred and intimate moments of another’s life. We encounter extraordinary acts of love and devotion, of trust and courage. Our days contain many moments of awe.’’
Certain passages from the text above are from: B Feldstein, Bridging with the Sacred: Reflections of an MD Chaplain. Journal of Pain and Symptom Management. 2011; 42-1:155-161.
Interview conducted by Julie Croteau and edited by Dorothy Lane Ryan.