The Heart To Heart Of The Fellow Traveler

I work as a Palliative Care Chaplain in Los Angeles for MPTF, a midsized nonprofit. Palliative Care is a medical specialty rendered by a team which has at least the four pillars described by CAPC (Center to Advance Palliative Care) as the “gold standard:” doctor, nurse, social worker and chaplain.  Sometimes it is the chaplain who can unlock the mystery in a difficult case.

My patient “Jim” (name changed) is a 50-year-old man with a wife and two young daughters, ages two and five.  Jim had been diagnosed with fast progressing ALS. His wife had the burden of caring for her husband as he fought to hang on to his independence and t being the “man” in the family even as his body insulted him daily.  Our team provided the family with medical care, case management, social work support and open-hearted chaplaincy. But Jim’s wife “Sandy” (name also changed) was having great difficulty not only keeping up with two young children, a husband who was increasingly becoming more physically and emotionally dependent on her, all while managing her own human needs.  She even struggled to find time to sleep. She was the only one who could understand his verbalizations as he refused to use a visual device.  She’d feel guilty if she could not be his all or his everything at every moment. She was constantly exhausted doing car pool, health care, family finances and on and on. The girls were traumatized when daddy choked trying to get in a sip of water or a bite of food against medical orders due to aspiration risks. I wondered what I could offer beyond witness, beyond accompanying?

One of the things I, as a chaplain, struggle with is the intense feeling of inadequacy and authenticity when verbalizing “I hear you” or “I understand” or even “tell me more” as I watch the wounds fester. Enter the Bat Gil.

The concept of a ben or bat gil is Jewish.  It means a peer or a good friend, but it is actually more than those. It is a person who walks in your moccasins. It is a person who has been on your road and knows the terrain.

Several years prior to meeting this family, I had the occasion to be on the inpatient team treating another young father with ALS, two young daughters, a young wife (who also thought she was superwoman.) With the team’s approval I set the two women up for a meet. HIPAA guidelines followed. They spoke for a bit, privately, and didn’t have to report any of the conversation to us.

Following this meeting, Jim’s wife understood in a profound way what she had to do for the sake of her husband, herself and her daughters.  She began exercising control of the family finances and, discussed moving Jim to a long-term care facility and set up a meeting with an attorney to examine her rights under the Spousal Impoverishment Rule to protect the future of her children.

No one could have spoken as clearly or been as openly received as the Bat Gil.  As chaplains we are trained to do many things.  But sometimes the right voice may not be ours. Sometimes the heart to heart of the fellow traveler can be a tool worth picking up.

Blog contributed to Ezzree by Rabbi Arthur Rosenberg