In the rooms of COVID-19 patients at Stanford's hospitals, among the tubes, monitors and masked care providers, Samuel Nkansah brings spiritual care to the patients' bedside.
Nkansah is a board-certified chaplain (BCC), who as a member of Stanford's Spiritual Care Service team helps support and connect patients with their faith.
Nkansah recalls the first time he entered the room of a COVID-19 patient. The moment he came near, the patient -- a person in palliative care so ill he could not speak -- reached out to him.
By the patient's bedside, the two locked their hands together. "I could see his tears flowing forth, and I too shared tears with him," Nkansah said. "It dawned on me that day -- COVID-19 patients are robbed of a fundamental need: human touch."
In the many months since, he has clasped hands with many COVID-19 patients, providing connection, support.
"If you are being carried away down a fast-flowing river, you will reach out and grab anything for help," Nkansah said. "Even if what passes you are cobwebs, you reach out."
Although he is the only chaplain meeting with COVID-19 patients in person right now, the rest of the spiritual care team has not let physical distance deter them from providing care.
Faith at the bedside
Last December, a severely ill COVID-19 patient of Jewish faith was in the hospital during Hanukkah.
"This patient was very close with his brother, who, under any other circumstance, would have come to the hospital," said Bruce Feldstein, MD, BCC. The care team had been in touch with the brother and knew he and the patient were worried and feeling isolated. "Being in the hospital with COVID-19 is anguish enough, but all while alone and during a special holiday, those feelings are amplified."
To help, Feldstein turned to two of the patient's nurses, sharing with them the idea of Hanukkah as a representation of holding onto hope, and giving them a photo of a menorah to symbolize the support and unity they all shared with the patient during that time.
"As a nurse I feel it's important that the patient not only receives medical care, but that they're cared for spiritually, too, because it can be an important part to their recovery," said Rocio Nunez, RN. She and another nurse placed the photo at the patient's bedside and wished him a happy Hanukkah. "We took a picture, sent it to his sibling and relayed the story, which was comforting for everyone involved," said Feldstein. "It feels immensely meaningful that, in the middle of all this darkness, there are still these points of light, where human touch and kindness shine through."
Connecting with your source of strength, comfort
Health care chaplains come from a variety of spiritual backgrounds but they support people of any and all faiths. Nkansah is a Catholic priest. Feldstein is of Jewish faith, and their colleague Anna Nikitina, BCC, who works with palliative and intensive care patients, is an Orthodox Christian.
"When I am with a patient, if they are Buddhist, I invite them to call upon Buddha; if they are Muslim, I invite them to call upon the Almighty Allah; if they are Christian, I invite them to call upon God. And then I invite them to let that source of strength lead them," said Nkansah. "I find that this helps them feel less anguish, more comfort, and more ready to comply with what the medical care team asks of them."
Humans find spiritual meaning in myriad ways, Feldstein told me. When he visits a patient (in-person after they've recovered and virtually) his intention is to meet them in their world as they see it. "If I had to pick out a single verb to describe what we do, it would be 'accompany.' That's the core of the service we provide, we accompany you in your spiritual world, and help connect you with your source of strength, comfort or meaning, whatever that is for you."
The crab and the wave
The chaplains tread in treacherous waters -- where infection is near and fear and loneliness are heightened.
"Often, my colleagues will ask me, 'Father Samuel, how are you so calm about this? Why aren't you afraid?' And I tell them, I learn from the crab."
Nkansah, who grew up in Ghana, says there's a saying that comes from the coastal towns of Ghana: The crab cannot be bothered by the storms and crashing waves of the sea.
Nkansah explains: If a crab is not careful, it could get dragged out to sea. But it has learned. If it sees a wave coming, the crab digs its legs firmly in the sand so that when the wave hits, it may feel the wave's force, but it will not be carried away.
"I see COVID-19 as the sea storm and, as a chaplain, I see myself as the crab, walking to my patients amid all the stormy weather. If I become scared or emotional, how will I be able to take my gorgeous walk on the seashore, knowing that what I do with and for people in the hospital is needed?" said Nkansah. "When I see a wave coming, I do not need haste, neither do I need to panic. I do my own spiritual practices, I collect myself, I stay nourished and hydrated, and that is how I stay grounded."
Feldstein and the other chaplains also provide spiritual care for providers -- the comforter of the comforters, Nkansah says. Early on in the pandemic, Feldstein created Reflection Rounds, where health care workers and medical students can gather in person on a regular basis to support one another.
"It's a session that's facilitated by a chaplain and a physician during which a small group of colleagues, be it doctors, nurses, residents or other hospital staff, can come together and discuss their experiences on emotional, spiritual level," said Feldstein. "We talk about the things that don't get talked about at regular rounds, or the kinds of experiences you can't share with people outside of the hospital because they just won't understand."
The reflections, launched in response to the pandemic, have helped care providers from around the hospital connect and support one another through plausibly the most difficult time of their career, said Feldstein. "We're all people who have said yes to medicine and to healing. And because of that commitment, there's a shared understanding that bonds, nourishes and strengthens us."
Inspiration in a trying time
The chaplains have found that COVID-19 patients are often suffering from another severe ailment: loneliness. Their role in kindling hope and strength through family and faith has become even more pressing, said Nikitina.
"A big part of this role is to help facilitate the connection between patients and their families," Nikitina said. "I call the families of patients to tell them I've just been with their loved one, and I assure them that, alongside their medical care team, there is someone at the hospital tending to their spiritual well-being, too."
She provides direct support for the families as well, often leading or participating in prayers over the phone for recovery. Her prayers are tailored for each patient or family member. A patient recovering from a lung transplant as a result of severe COVID-19, for example, asked that Nikitina send a prayer of gratitude to God, to say thank you for answering his prayers, and for seeing him through this life-saving surgery.
"I am newly inspired by the patients that I see every day," said Nikitina. "Seeing the resilience and how they find strength to cope with the illness, and the desire to strive for wellness and healing -- their bravery. Just being a witness to this gives me strength to continue my work."
The Voices of COVID series captures the stories of the many people at Stanford Medicine who have been stepping up to the challenge of the pandemic. Follow along on social media and look for new stories regularly.
Photo by Rajesh Rajput