The town of Kailua on the windward side of Oahu is guarded by a lush, majestic face of volcanic rock. Across town is a gently sloping beach that travel critics have named one of the nation’s 10 best.
With a boyish smile that rarely leaves his face, Dick Millspaugh recalled the years he spent between these landmarks as pastor of a United Methodist church.
All was not well.
Working as a pastor in the 1970s was fulfilling, but paperwork and fund raising took up the time he wanted to spend helping churchgoers as individuals, he said.
“I wasn’t big on trying to raise money, or increase the number of people coming to church, or the preschool program, negotiate leases,” he said, his voice hoarse and comforting.
For two years, he prayed for guidance and filled out assessments to find a more meaningful path. He found his calling as a chaplain.
Millspaugh moved with his wife, daughter and son 4,000 miles to Minnesota for a two-year training program that taught him as much about himself as it did about his new vocation.
Now, after two decades as director of Boone Hospital Center Chaplaincy Services, Millspaugh has again followed his calling. On Sept. 15, he stepped down as director and moved to the San Diego area to work as a staff chaplain for the Veterans Affairs Medical Center in La Jolla, Calif.
Millspaugh said his wife, Carol — herself a Columbia pastor — will soon join him in the town where they married, fulfilling a long-term goal. Yet on Millspaugh’s last day at Boone Hospital, he said it was sad to leave Columbia.
“It’s a wonderful city,” he said. “Boone has been a great place to work, just a great place to grow both personally and professionally.”
By taking what he calls “one step toward retirement” — working as a staff chaplain — Millspaugh hopes to spend more time one-on-one with the patients he first felt called to help.
As director, Millspaugh worked with both the staff and the community, he said in an earlier interview from his spacious third-floor office.
“But at the heart of what we do as chaplains is the work with our patients. That’s the reason we’re here and that’s always rewarding — to feel like you really make a difference in supporting someone at a critical time in their lives.”
Millspaugh is one of about 5,000 certified professional chaplains nationwide, said George Handzo, president of the Association of Professional Chaplains. The figure has grown steadily in recent years as hospitals and other institutions integrate spirituality into the healing process, and the number of practicing chaplains who are not certified by pastoral care associations is estimated to be much higher.
When Millspaugh started as Boone Hospital’s first staff chaplain director in 1983, it was up to him to start the chaplaincy program from scratch. He met the challenge, setting up workshops for clergy and a forum for bioethics issues. Soon after, he groomed Boone Hospital to host mid-Missouri’s first accredited program to train aspiring chaplains.
‘An intense ministry’
With so many new programs, Millspaugh needed extra hands. In 1988, he hired Scott Jensen as a part-time chaplain. Jensen accepted a full-time chaplaincy at Columbia Regional Hospital a year later, but he still considers Millspaugh a mentor. “He has a heart for chaplaincy,” Jensen said.
Jensen, now 45, had ministered at several churches, and the church has been an important part of life for him and his family since his youth in Columbia. After graduating from Southwestern Baptist Theological Seminary in Fort Worth, Texas, he decided to try a course in clinical pastoral care.
“I wanted to understand myself as a minister and as a person,” he said.
The course gave Jensen a chance to be with people in time of need with less of the routine work that comes with church service, he said.
Once during his training, the family of a teenage girl who had attempted suicide asked for his guidance. When the girl died, “I remember feeling there was really nothing I could do except sit down with them and pray with them,” he said. A month later, the mother called and thanked him for being there with them — for “keeping her in touch with God.”
Now a hospice chaplain in St. Joseph, he spends hours on the road, but to Jensen it’s worthwhile. Chaplaincy is “more meaningful” and “more of an intense ministry,” he said.
Not long after Jensen left Boone Hospital, Ruth Lane came on full time. It was her first job as a professional chaplain.
Lane, 58, was drawn to chaplaincy while finishing her pastoral care requirement at Methodist Theological School in Ohio. At first, she thought it might be too late in life to start as a chaplain. But she found that many people looking for meaning in life chose chaplaincy as a midlife career.
Lane starts each day by checking for new referrals in her softly lit office. Chaplains are expected to spend more than 15 hours of the day with patients — about 18 visits per day. But her 12 years at Boone have taught her that chaplains should expect the unexpected. “You can plan your day and then anything can happen,” Lane said.
Yet the little surprises are part of the reward of chaplaincy. “A family may have a very concerned look on their face. You might have a pastoral care experience right there,” she said. “It’s almost as if the spirit led you there.”
Lane remembers visiting the family of one patient kept alive only by life support.
“Something ... told me ... to stay,” she said, mouthing words silently at first as she looks for that just-right phrasing. Lane stayed with the family at least two hours. She helped them decide to remove the patient’s life support. And she stayed as the patient died.
Sometimes, just having someone there is satisfaction enough for a family, she said. “There is a deep connection they allow you to make.”
Millspaugh said making that connection doesn’t mean chaplains can judge patients on rights and wrongs or recommend one solution to a problem.
“Pastoral care is working with the person pretty much as they are and letting them use the resources they have.”
And that, he said, is not easy. Professional chaplains help patients and families facing trauma to identify their own spiritual or religious distress, then assist them to find the resources they can use to alleviate the distress, Millspaugh said.
Doreen Rardin, coordinator of Boone Hospital’s palliative care program, said emotional and psychological suffering often must be addressed before patients can heal. Much of Western medicine focuses on physical wellness, but “it’s (also) their support system, it’s their spirituality that helps make people better,” she said.
A Christian chaplain should be able to offer basic ministry to most Christians and also be able to meet the needs of other faiths, Millspaugh said.
“The important thing is ... to know how to treat that person with respect, and honor their traditions, and help them find those resources that they need,” he said.
Some patients turn to a hymn or a prayer for comfort, he said.
“It brings them a sense of comfort, a sense of connection to something larger than they are.”
Others just want a chaplain to listen, even if the subject is not faith. Good listeners can help people discover their own sense of purpose, or a reason to keep fighting in the face of adversity, Millspaugh said.
Learning to listen
But the idea of just listening — without offering advice or solutions — was new to Millspaugh and his peers in the training program at Rochester Methodist Hospital in Minnesota.
“How do you join a person in their own anxiety and their own distress without trying to change them, without trying to fix them, without trying to tell them to do it differently than we do?”
To prepare as chaplains, Millspaugh and his fellow trainees were challenged to settle “unfinished emotional business” from their own pasts — with parents, God, the church — that could have clouded their understanding of patients’ needs, he said.
The Rochester program combined clinical care sessions at the hospital with group discussions of the chaplains’ reactions to cases.
“As (other trainees) get to know you, they’ll analyze how you have done as a chaplain,” Millspaugh said. “So you’re in the hot seat.”
Most chaplaincy candidates aim to be board-certified by one of several pastoral care organizations. Millspaugh, Jensen and Lane each completed a similar two-year training program, including a year-long application process for certification by the Association of Professional Chaplains.
Millspaugh later became president and board member of the association, which represents more than 150 faith groups. During his tenure at the association, he pushed for diversity among chaplains and coordination between chaplaincy groups, efforts he continues to support since stepping down as president to head Boone’s program full-time.
With 3,700 members — 2,200 of which are associate or board-certified chaplains — the Association of Professional Chaplains is the largest of the four main pastoral care organizations in North America.
Some hospitals hire volunteer chaplains, but Boone hires chaplains almost exclusively from the association and other accredited programs because of the rigorous setting of the profession, Millspaugh said.
“You never know what situation you might run into.”
Applications for certification by the Association of Professional Chaplains have increased every year for the past seven or eight years, said Jo Schrader, the association’s executive director in Schaumburg, Ill.
“There’s much more awareness of the spiritual component of health care,” Schrader said.
The National Association of Jewish Chaplains is smaller in membership, but it has also seen a recent increase in applications with more health-care organizations requiring chaplain certification, said Cecille Allman Asekoff, the association’s national coordinator.
Lane said completing her certification brought a sense of relief and fulfillment. Yet, the learning does not end with the certificate.
“It is an ongoing process of learning about yourself and pastoral care,” she said.
Despite its rewards, working as a chaplain can be emotionally taxing, Lane said.
“We’re human too. We hurt also,” she said. “It’s uncomfortable for us to bear pain. That’s why we get so much training.”
A community like the one at Boone Hospital Center helps chaplains avoid the trap of holding in their experiences and becoming isolated.
Jensen, who is married with two children, attended a clergy support group in Columbia and now goes to one in St. Joseph, which he said is essential for dealing with daily life-and-death issues.
“To try and bring that home and talk about it just didn’t help. They didn’t always understand,” Jensen said.
Chaplains are not immune from other day-to-day rigors.
Millspaugh’s days at Boone seemed too short, and he found himself “working with a full plate, wishing I had more I could give,” he said. And as a chaplain, he misses the intimate relationships local pastors often form with churchgoers and their families over time.
But it cuts both ways, Millspaugh said. Some patients tell chaplains things they might keep from a pastor, because the relationship is relatively brief but still confidential. It’s not unusual for a patient to say, “I don’t know why I’m telling you this. I just feel you are someone I can trust,” he said.
Lane said that despite its hardships, chaplaincy is replete with rewards for those who wait.
“People let you into their lives at very vulnerable times and share with you their struggles, their pains — basically their lives,” she said. “It’s a very privileged place to be.”
Jensen learns from what his patients tell him. “You get something out of the people you helped — whether it’s a thank-you or a note, or you can just see it,” he said. “Being with people in those most intense times is very rewarding because that’s where life is really lived, not in the more mundane things.”
Millspaugh said he always has something to be thankful for. “It’s constantly an opportunity to keep one’s perspective on what’s important in life — the gift of being able to breathe, to have a heartbeat, to be able to walk, things we only take for granted but can be gone in the blink of an eye.” He smiled.
“That’s a real blessing to being in a hospital setting. You get to go home and live your life and say, ‘Thank you for another day.’”