Virtually Being There

As I mentioned in my first pandemic blog, the issue of a chaplain’s presence in the context of distress has long seemed important. An embodied participation in events as they unfold is seen as critical to the practice of spiritual care. When God doesn’t appear to answer the deepest desires of human beings – for recovery or healing – the absence of a chaplain might feel like the confirmation of experience. Being there conveys pastoral response; compassion; and witness. This tragedy is not ignored – it has been seen.

During a recent conference on theology and Covid-19, I presented a paper on the topic. It is by no means a finished article, but rather a field report reaching towards theological reflection. The pandemic has provided plenty of good reasons to concentrate on the day job and shelve intellectual enquiry for better times. However, this suggests that theology is a task only for tranquil times and cloistered concentration, and I don’t believe that’s true. Theology needs to be done in difficult places and at difficult times or it risks becoming an irrelevance. Not only data gathering, but some of the thinking needs to be started in the compressed moments of critical times.

The conference reminded me of the existence of ‘trauma theology’ and the inspiring work of Shelly Rambo. Her seminal work, Spirit and Trauma: A Theology of Remaining, offers valuable material for anyone seeking to relate catastrophe and a theology which is engaged with people’s experience. At the moment the world continues to experience the sea-swell of sickness washing over every continent and island, leaving in its wake illness, death and all kinds of fear – from physical vulnerability to a paralysed economy. Rambo’s book takes its point of departure from hurricane Katrina and the devastation of New Orleans by a different kind of natural disaster. As she describes, while the critical time will come and go, the ‘after the storm’ remains. Global events of death and disruption linger long in the lives and memories of those affected, as we continue to see in the various ways by which WWII persists in both personal and public experience.

The impact of Covid-19 is already the subject of active contestation and dispute. Official narratives will be created alongside the stories of individuals who live this experience as a personal encounter with their mortality. As I observed last week, these stories have considerable power and can become something separate from the event itself – a mutating memory with the potential to shape and inform the present, for good or ill.

As a health care chaplain I often said that I tramped the familiar path between Good Friday and Holy Saturday. Usually, the resurrection was a distant possibility and the chaplain’s work oscillated between the moment of death and the experience of absence. Each death a figure swept from the landscape of someone’s life, very often creating the yawning gap of a potent presence. There was no magic which made this ‘alright’ but a painful living with what these defining moments of human existence mean for each of us.

Take courage; the time is near for God to heal you; take courage.

Book of Tobit, chapter 5 v. 10

The picture which heads this blog is of the Archangel Raphael, and was painted by a friend who gave it to me during my time as a chaplain in the NHS. These strange figures flit too and fro in the scriptures of the world’s religions, greeting and warning, announcing and healing. Raphael is associated with the latter and can be found, amongst other places, in the Book of Tobit. Here Raphael both announces that a time of healing will come and offers to be a companion and guide on the journey which lies ahead.

In time we shall all live with the ‘after storm’ and wrestle with its consequences. There will be those keen to shake the dust of Covid-19 off their shoes and spring forward into a bright tomorrow. Yet this event will not be dismissed so easily. In health, the economy, psychology and spirituality, the question will not be ‘shall we continue to think about it?’ but rather how that thinking will be done. Faith affirms the persistent promise of hope – there is a greater good to which we move – while offering to stay with us while we make this journey. As in the Bible, angels may appear at first as strangers, but in time those who stay with us and guide us come to be known for the hope which they embody, and the transformation they bring.

Telling Tales

I have never doubted the power of story. As a hospital chaplain it was my privilege to hear countless tales of people’s lives, their hopes and fears. At times I felt I was curating these stories – being handed them like treasured items held close to the heart. So fragile, that mishandling them might cause these heirlooms to break. There was something very sacred about this curating. Being invited in whispered tones to hold this precious fragment; a meeting, a marriage, an illness – stray episodes of significance that only made sense lodged in someone’s long-crafted discourse.

Let us suppose our world is attacked by war, by the horrors that we all of us easily imagine. Let us suppose floods wash through our cities, the seas rise . . . but the storyteller will be there, for it is our imaginations which shape us, keep us, create us – for good and for ill.

Doris Lessing, ‘On not winning the Nobel Prize’, 2007

These key stories were often decades old, and rooted in someone’s sense of identity. The elderly woman, many years after her husband’s death, squeezing my hand as she told me once again about that fateful day when her life changed forever. The compassion of the nurse; the matter of fact tone of the doctor; a relationship which even death could not divide.

We are made up from stories. They are not just the furniture of existence but the walls and roofs of our reality. Sociologists know the power of the tales we develop during illness. As I found in my work on the wards of the NHS, new experiences need to be accommodated in the stories held dear. The person who feels ‘lucky’ that they could sign up for a particular clinical trial. Equally, the person whose stories appear to lie in tatters: a pregnancy ended and a life imagined suddenly gone.

During the Covid-19 crisis all kinds of stories are being created. For many this will be a watershed event, a moment which divides the before and the after, the old world and the new. It goes without saying that we may not like the ‘new’. It could be a time of previously unknown austerity for the world, an era when the taken-for-granted certainties of the West become persistent doubts. I recall living in Argentina in the late 1980s and learning of the frequent experience of people going unpaid for several months. Teachers, breaking up for summer holidays at Christmas, and unsure when the next pay cheque would arrive. Even when it did, it was eroded by inflation – but perhaps that was all part of the plan. The micro-securities of the West are aberrations in historical and global terms. This may be something, unwanted, which we shall have little choice but to learn.

Doris Lessing was right about the power of stories. They can transform the disaster of Dunkirk into a different kind of triumph, and open windows to see the world in new ways. The stories being shared on social media by the Black Lives Matter campaign are digging at the hidden foundations of the privilege on which power has rested for so long. The urgency of these renewed narratives enable people to see that inequality is not the fault of the poor and the oppressed. It is wired into societies and institutions which have chosen to look the other way and long avoided the tough questions about what we choose to celebrate; replicate and elevate.

Our daughter is about to graduate – or would be doing if the ceremony could happen. It reminded me of my graduation from the University of Hull in 1986. Antonia Fraser gave the speech and recalled a time she had been at a State function in Turkey. In a heated exchange about human rights she swore extensively to emphasise her point. The host was shocked at the language – but didn’t appear to be disturbed about the realities of injustice. She cautioned us to focus on the things that matter rather than the distractions of civility. This is one story that has become part of my story.

The last word – a hopeful word – needs to go to Doris Lessing and the conclusion of her tour de force Nobel acceptance speech:

It is our stories that will recreate us, when we are torn, hurt, even destroyed. It is the storyteller, the dream-maker, the myth-maker, that is our phoenix, that represents us at our best, and at our most creative.

Thank God, I have no doubt that they will.

Moral Injury of a Nation

By the South door of York Minster sits a fine statue of the Emperor Constantine. His left hand rests on the pommel of his sword while the right is extended at leisure, hand relaxed. It is here that Constantine was proclaimed Emperor in 306 AD; leader of an empire in his mid-twenties.

Around the time of lockdown Constantine was given a surgical mask. I’ve no idea why, or by whom, but the addition reminded me of how power has been humbled by something so tiny. All the weaponry of the modern world is powerless in the face of this tide of sickness. The Prime Minister’s personal protection officers stood no chance of averting contagion and its consequences. Security gates, alarms and early warning systems, were useless when it came to Covid-19. While spending billions on sophisticated defences a virus has stolen into our lives and wreaked havoc. Tens of thousands dead; personal freedoms curtailed; economies heading into sharp decline with astonishing speed.

Even as we attempt to negotiate an exit from lockdown our capacity to return to anything like normality is in serious question. The threat of a second wave hovers over us and the NHS is on standby, prepared for its impact. We are both heaving a sigh of relief that the worst seems to be past, while feeling apprehensive about the consequences of more people being closer together.

Hidden in the worries about wellbeing and economic survival there is the risk of collective Moral Injury. This is a state of suffering distinct from PTSD and burnout, which reflects the implications of actions – or a lack of actions – in particular situations. Moral Injury as a distinct term is not yet twenty years old but offers a new way of understanding the impacts of behaviours which leave a deep sense of moral consequence. While initially developed in the context of military personnel it is a concept already recognised for its relevance in frontline health services. However, whatever moral pressures health systems were under before Covid-19, these have been magnified by the current crisis. As a fuller picture emerges, heath professionals are beginning to wonder what unintended consequences have followed a policy to send patients back into residential settings. This post-event dawning realisation is the stuff of Moral Injury.

Moral Injury is an evolving framework for the understanding of critical situations and their consequences for individuals. However, in the light of Covid-19 it is reasonable to ask whether this individual experience might take on a collective expression. If as a society we are shown to have given older people such limited priority in our planning and provision, what lasting consequences will there be for our national character? As I argued in a previous blog, there is a real question – when compared with other nations – as to whether the UK allowed a form of social amputation. James Childs, writing in March 2019, suggested that Moral Injury could have a kind of corporate manifestation:

When actions of government violate the ideals of our communal spirit, we as individual citizens, though not guilty, are nonetheless responsible for allowing our government to do such things and, therefore, share in that guilt as a community.

Childs, J., 2019. Can a nation suffer moral injury?. Dialog, 58(1), pp.3-6.

There is a long way to go before we emerge on the other side of the acute crisis caused by Covid-19. Perhaps the lesson we need to draw from Moral Injury is the need to allow space for the possibility of corporate responsibility in the memorial events which will take place. To acknowledge that even when the last person infected with Covid-19 has emerged from isolation, there will be questions we must live with for a very long time to come. The tempting short-term option is to sweep it all under the carpet (‘what else could we have done?’) rather than address real questions of responsibility with openness and mutual compassion. The emerging evidence of Moral Injury requires us to consider the longterm emotional cost of our response to the virus and act now to mitigate its damaging aftermath. After all, a future which aspires to achieve wellbeing for all can never be built on a buried past.