Episode 40: Chaplaincy at Birmingham Children's Hospital with Andrew Phillips
[Music] Welcome to the Loved Called Gifted Podcast. This is your place to come for musings about spirituality, identity and purpose. I'm your host, Catherine Cowell. [Music]
So today I am joined by the Reverend Andrew Phillips at Birmingham Children's Hospital. So thank you very much for joining me, Andrew.
A: Thank you.
C: Do you want to introduce yourself a little bit and tell us a bit about where we are?
A: Yeah, my name is Andrew Phillips and I'm one of the chaplains here at the Birmingham Children's Hospital. And I'm an ordained Baptist minister. I've been here now just over seven years. And I have to say I love it. I love the work. Sometimes it can be challenging, but it's always rewarding. It's a good team that I'm part of and I'm very, very blessed to be part of this team. Yeah.
C: What drew you to chaplaincy and chaplaincy here in particular?
A: I'd been a chaplain in the university as part of my ministry in my second church. I wanted to explore chaplaincy. So when I left my last church, moved into school chaplaincy, but wanted to see whether or not hospital chaplaincy was something as well. So I was volunteering as an honorary chaplain at my local hospital. And as I was just across the way from this hospital, I decided to make inquiries. To be honest, I didn't really think I would like it. So it was quite a surprise, even a shock when I discovered that I not only liked it, I loved it. It was a really good fit for me. I'm not absolutely sure why that is because it is a challenge sometimes. If you go on intensive care, it is exactly what it says on the tin. It's intensive. There's 31 beds, which is an extremely large intensive care unit. I think it's the largest in the country and you can have some seriously sick children in there. Thankfully, the majority do get better or recover and move to other wards and go home. But sadly, there are a number who do not and who die. And that is always a challenge. So our role is really threefold within the hospital. Pastoral, spiritual and religious care. And that is given to patients, their families and staff. So we offer pastoral and spiritual care to anybody in the hospital, whether they have a faith or no faith. And it can be of another faith. I can still offer pastoral and spiritual care. So pastoral care is where it's one human being walking with another. Just being there and saying, "I'm here for you, even when it's getting very hard, and just to love you through this time.”
Spiritual care can often be confused and in fact there's overlap between pastoral, spiritual and religious care. But spiritual care, in essence, is making connections. It could be, you know, meaning making as well. Why is this happening to me or to my child or something like that? So it's big questions of life as well. Religious care is exactly what it says on the tin. And that's bespoke. For Christians, it could be prayers of blessings, baptism, end of life, rites. That could be the same for whatever faith a person has. If a Hindu, Sikh, Muslim, children would have that bespoke religious care for them and their families by the appropriate chaplain. Occasionally we do get asked, for me as a Christian chaplain, to be asked to pray for families of other faiths. It doesn't happen often, but it does happen. So that's roughly how we go about what we are doing. And the staff is exactly the same. We will work with staff and support them and care for them. We do that in groups. So for example, I will be going down to A&E every Wednesday morning at 8.30 to do a staff support session. Sometimes they're just too busy. And, you know, there's too many children in for them to release staff to have a staff support session. So we can have average four to six. Last week there were 15. And it ranges from care support workers to doctors.
C: What does that look like? What's your intention for that?
A: It really depends on the staff that are coming. I don't have an agenda, so I don't come with, “this is what we're going to do today”. So it's driven by the staff. What are they doing to look after themselves? And we can then explore how they're processing their emotions. And staff just need an opportunity to be able to process their emotions and to be able to talk about the events that led up to it. It's a bit like a debrief, really, the events that led up to the child's dying and how they feel. So it gives them the space and the opportunity to talk, give them the space to laugh, talk about mundane things, just to be there. And out of those group sessions, there might come up a staff member says, "I want to talk a bit more deeply about something. I don't want anybody else listening in." So we'll have one-to-one sessions, usually in this room here. So in terms of pastoral and spiritual care, when we're working with children, I've got an activity bag and in fact all the chaplains do, it's here in front of me. Just at random, there's this which looks a bit like a rugby ball on a stand, but it's actually a Russian doll. So there's four more in here. So when I'm working with a child, I'll just say, just decorate it how you want. So one child, he was about eight years old, I think, he decorated figures from Star Wars and he decorated them all, all the way down to the smallest one. I took a photo of it, which I might be able to show you afterwards. And I asked him what his favourite Star Wars character was and he said Darth Vader. I was expecting, you know, Luke Skywalker or Obi-Wan Kenobi or someone, but he said, "No, Darth Vader." And I said, "Well, that's interesting. What made you choose Darth Vader?" And he said, "Well, Darth Vader starts out a baddie, but he becomes a goodie in the end."
C: That is interesting, isn't it?
A: Yeah, it's like a kind of redemption thing. So he talks about how people can change. So out of this one activity, we then start a conversation about how people change and what makes them change. So you've given them free space to express whatever's going on and then you can build on that. And then we've got decorating a mug. Most of the things that are in my bag, they can keep. So decorating a mug, they can decorate it how they want, they can make a present for one of their family members if they want to. And again, that's really interesting what they can come up with, what they draw. And decorating, this… this is an elephant, a kind of paper mache elephant, I think. And they can decorate it. And then we can talk about, say, we talk about the elephant in the room. What's not being said within your family might be, "Well, my illness has not been talked about." So we can then begin to talk about their illness and maybe encourage them to talk about it in front of their parents. If the parents are wanting to protect the child, which is exactly what a parent will want to do. But it might be that the child knows exactly what's going on, but it's the elephant in the room. No one's talking about it, but it's there. So from this activity, we can begin to discover if there is something that's not being talked about. It might not be the child’s illness, it might be something else. But we can then begin to encourage the child to explore that and to see how they can deal with that in a way that's appropriate for them. And then we've got storybooks, we've got colouring things that they can do. We've got all kinds of stuff. Oh, this is a nice one. I like this. This is a good one. This is a really useful box for keeping, putting things in, as in Winnie the Pooh. There's the stickers they can stick on, they can color it in. And then I talk about this box being like holding treasure. I say, well, what do you treasure? What's valuable for you? And you could put in this box a bit like a TARDIS. Imagine it's a TARDIS. If you could put anything you like in that, what would you put in it? And then from that, we can begin to discover for the child what is precious to the child and how we can encourage and help the child explore that and articulate that a bit more. It might be, they might say, their parents. I say, “well, have you talked to your parents about that and that they are special to you?” “Well, no”. “Maybe you could.” And maybe, you know, this box you could put your precious things in that you can then say, well, to mum, “you're precious to me”. So it's a way of just being able to open up the child's feelings to being able to articulate them. So we use this quite a bit. Sometimes we just have fun. So there was a time when I was on intensive care with a child who was seriously poorly, but he got one of these little guns that threw out foam tubes about foot long, eight inches long. And he was right opposite a wash basin that came on when you put your hand in front of it. You didn't have taps. So we spent half an hour, him firing it across the corridor. See if you could turn the tap on.
C: Oh, brilliant.
A: And so I'd run across and that kind of loaded up again. And it would be my turn right on. And so we spent half an hour and nurses would be dodging the foam missiles as they went across the walkway from the bottom of his bed to the wash basin. No intrinsic value except it lifted his spirits. It gave him a laugh and he enjoyed it.
C: That sounds like quite a lot of intrinsic value.
A: Yes. But we didn't talk about that. We just had fun with doing it. I didn't kind of ask deep questions about the meaning of what we were doing. We just had some fun. We did do an exercise later with the mum and he did it for his mum and he wrote on it, “Love you to the moon and back”. Now that because we built a relationship, we could then do the activity with the mug and we could begin to talk about what meant something to him. But this is a children's hospital. One of the things that I find really helpful is that we really need to take seriously play. That sounds almost like a contradiction in terms. But play is intrinsically important not only to children but also to adults.
A: And we lose too much when we dump play, when we grow up. You know, we put away childish things so to speak. I walked on to Carthage ward one day. There was a four or five year old playing with his Batmobile and Batbike and stuff. So I just, as I was passing, I joined him. So we had a wonderful time seeing the Batmobile blow up in flames and then suddenly get restored and we play again for a bit longer. And after we played, he then informed me that Batman had bad breath. No idea where that came from. But that was okay. Very interesting. So the stuff they come out with sometimes is okay. But there you go.
C: So quite a lot of what you're doing then is creating space for these children and young people.
C: That is entirely their space.
A: It's their space. Because a Chaplain's task is to create a safe space for the child, the family and staff. It's their time. What are they going to do with it? And for us to then try and help them to see what they're doing. Just to reflect back, which is trying to say, "Am I getting this right? Am I sensing that this might be what you're feeling?" Yes or no. We're just helping them begin to make sense of their world and make sense of what's going on in their world so that we're not trying to put kind of deep and esoterical meaning to it. It's just, "See where this goes." Yeah. The key thing for me, for every person that we're working with is active listening. We have to listen with our whole being to their whole being. We have to listen not only to what the words are saying, but we have to listen to what they're not saying, how they're saying it. We listen to their bodies. We listen to them as human beings. And we seek to just accept them where they are and to say, "You're okay. Even if your world is not okay, you're okay. We're just going to walk with you through whatever is going on.” Pastoral, spiritual and religious care is our kind of three planks to the constituency of patients, families and staff. We're here really to soothe and lift spirits. And to play that game with his foam gun was exactly that. It was to lift spirits. It was to give them, to go around with a sweet tin to staff is to lift spirits. It's to put a smile on their face. They might have had a really rough start to their shift. I rock up and go, "Here you go. Would you like a goodie? Have a rummage. So don't just kind of take the first thing off the surface. Have a delve. See what you can see.”
C: You were showing me pictures of chicks that you've hatched at the back of the chapel.
A: It lifts spirits. Sadly, we're not going to be able to do this this year. But we have an incubator which we would then incubate the eggs to be hatched at Easter. First hatched. They can make a right racket. You can hear them down the corridor. So when the chicks hatch, staff come, patients come and hands of a child. She's sitting at the back of the chapel, holding a chick in her two hands. She's cupped her hands, like as if you're holding some water in your hands. And she spent 15 minutes just staring at this chick. And the chick fell asleep in her hands. I mean, she'd just come off the ward to sit and just have some time. And what it does for them is just priceless. And it does it for the staff as well. The staff will want their photo taken with the chicks. Senior members of staff in the hospital as well as more junior members of staff. They all want to have their photo taken with chicks. And often these kinds of things have come almost organically. We have a memorial picnic in September for families who have lost children in the hospital. And families come back every year. Not in a morbid way, but in a way to celebrate and to remember their children. And when lockdown came and just after lockdown, we had to do things differently. So we did it in a way where we could just spend time informally with families. And at the end of that day, we found that it worked much better than the way we did it before. So we never went back. When all the restrictions were lifted, we carried on using the same method and format. It's at the National Memorial Arboretum in September. And we have activities for the children and the siblings and families to do together to remember their child. And then there's a walk, a riverside walk down to our memorial tree. And then they can put a sunflower with a label attached to the message for their child on it. And they can do it as a group or individually walk down to the memorial tree. And we just chat with the family and just pick up from where we saw them last year. And sometimes people come to that and also to the memorial service at St Chad's, Ramacathet, Cathedral in May. So we'll see some of them twice a year. But it's like they feel comfortable because we're just there for them. And we can just listen to their ongoing story and sometimes more children have been born. And we get to know them and we get to know the other siblings as well and other members of the family. The chaplaincy has published quite a number of books and publications about pediatric chaplaincy, working with sick children, etc. Which are cutting edge, I think, in terms of what we are about. And yeah, so we have a, we call it a bereavement pathway. So when a child dies, within a month or so, we will send a letter out with a booklet for them. Depending on their faith, if they have a faith or no faith, we'll send an appropriate booklet with an invitation for the memorial service and the memorial picnic. And also, the anniversary of their death, we'll send an anniversary card. And we'll send it for two years because we had feedback from families to say that people remember after the first year, but after that they forget. So we then extended the time that we send an anniversary card to two years. So I've just been sending out some cards this morning to families who lost a child in the last year or last two years.
C: You were saying that what happens here is quite cutting edge and some of what's been written about is quite cutting edge. What do you think the chaplaincy here has contributed to understanding of what chaplaincy is about?
A: I think it's enabled people to see from the research that's been done, that there is a reasons for what we're doing. The methodology is robust. So for example, the things that we're doing with the activities, that's based on research, which has then appeared in the books that have been published. So what I've been saying to you this morning has already been kind of trialled and researched and the findings have been being looked at and thought, yeah, this has some attraction. So if I'm talking to anybody, I was talking to a consultant a while ago about what we do. So it's not just, we thought it was a bright idea, let's just go and do it. We sat down, we thought about it, not me personally because the research was done before I arrived here. So I'm kind of riding on the back of a lot of other people who have done tremendous amount of research into making sure that what we're doing has validity and that we can say these are the reasons why we're doing this. So the three main areas, pastoral spiritual and religious care, come out of that.
C: Yeah, so talking about your bag of tricks, your activity bag, what are the kinds of things that the research has told you about what that does for people?
A: It gives people a sense of worth, a sense that there is meaning to things. So for example, a child who came into hospital while I was working with her, fear was a disconnect between her and her family. She feared that because for her, the family was the key thing. So the activities that we were doing, like decorating a mug, which she did for her dad, decorating another one that she did for her mum, was to help to reinforce that connection because they were miles away looking after her siblings. So she felt threatened that this connection she had with her parents, which she took very strongly, was threatened. So she wanted to do something that would help in her mind to strengthen that connection. So this was a key spiritual activity for her. So this came out through my conversation with her. At the end of it, you can begin to then ask, how do you feel now? You can ask a graded question, okay? And I'll scale it one to ten. “How do you feel? One is, don't talk to me. Ten is, I feel really, really wonderful. Where would you be?” And you can ask that at the beginning of the session and you can ask it at the end. You can say, “how do you feel now? And what's made you feel a bit different?” So you can begin to have some degree of validity of what you've been doing. So I can ask that with staff as well. I can ask, “okay, where are you on that scale?” “I'm a four”. At the end of it, “I'm a six”. “Okay? You've made some movements. What's made you make that movement?” So you can begin to kind of tease out what's doing it for them. “Has this helped?” So we're always seeking to ask questions about, is this working? And never assume, assumptions can, you know... Yeah. So we try not to make assumptions. We try to ask questions that really do matter. For many children, we can work with them for months and never get to the religious bit. In fact, I worked with a family and never got to the religious bit. Because our strap line is, and it's on our website, is that we won't mention God unless you do.
C: Right. Yeah.
A: If they don't mention God, we don't. We'll just work with them. We'll walk with them. If they mention God, then we won't. If they want prayer, then we'll pray for them. If they want a blessing, then we'll do that. I had one family. The child was about 15. The parents wanted me to pray for the child. I said to the child, because he was old enough to make his own mind up, said, "Would you like me to pray for you?" “No”. So I didn't. But the next time, the parents wanted me to pray for him. And I said, "Would you like me to pray for you?" “Yes”. I think he really wanted to find out whether or not he was in control, or he was in charge, or were his parents. So we want to bring autonomy. Because when children come, as you know, if you go into hospital, people rock up, take your blood, put things into you, take your temperature, take your blood pressure. You have no choice in the matter. If I rock up, if they don't want anything to do with me, they can just say, "Go away." And I go away. But if they want to have an activity, they can. They can choose any one of these activities or none at all. It's entirely up to them. But if they don't want me to pray for them, even if the parents do, the child trumps the parent.
A: Because I need to honour and respect that child, and give them the worth that they deserve, and not just kind of go, "Oh, I'll do it anyway." Then they want me to say, "I'm going to do it." "I can't do that. That's not right." So it's all driven by what the other wants, whether it's a member of the staff, a family member, or a child. What do they want? So with the activities, which one would you want to do?
A: Do you want to do one of them or none of them?
C: As you say, it is a context where a lot of autonomy disappears from people. The illness itself is not something you can have control over often. The process, what people are going through, isn't something that you have to resolve.
A: And if you're four years old or three years old, and you're suddenly in hospital because your liver is failing, you've got an autoimmune disease and it's attacking your liver, it's a scary place. Sometimes they can recover, the alternative can be controlled, but sometimes it can die to liver failure and they need a liver transplant. But coming into hospital just full stop is scary. And if you then have, right, getting to your child’s illness, and then your parents leave because they've got a room in London, and they might be just down the road, but it's not in the room next door. No. And they're scared. They're absolutely scared. They don't know who these people are, they've got a teacher they've never met before who's coming to teach them if they're at school age. It's really scary. So if we can make some place that gives them a safe space, that gives them a space where they can be themselves, where they can say, "No, I don't want to do that." Or, "Yes, I want to play with this." And they can. And they can keep some of the stuff. There's only one activity that I've got in here, which they can't do, because I'd be forever running out of it, which is the dice game. There's six dice in here, and there's got pictures of all kinds of stuff on there. There's a football, there's a sad face, there's an ice cream, there's a bicycle, caravan. When you roll the dice and you make a story of what pictures come. Really interesting what comes out, just to see what they talk about. Or we do it so that I might start with one of the pictures, and then they carry on, and we do it that way. That goes down really well. But all the things are workable. So, to know why it's just... But the other things, because they're in plastic bags, they keep them then. It's theirs to keep. But these are...
C: They’re really nice, aren’t they?
A: It's just a way of getting their voice heard. That they matter. That what they have to say is important. I just love doing this.
C: So how has your understanding of children's spirituality shifted, changed, developed through this work?
A: I think we underestimate the real awareness that children have of spirituality and of God. I think we really underestimate the sensitivity that children have. I can talk, and I don't use baby talk with babies. I just hate this. I think it's in something. It looks really weird doing it, or I'm certainly not going to do it to a baby in hospital here. So, it happened twice, and both babies were about two weeks old. And I was talking to this baby, and the baby was just engrossed looking at me. I mean, I talked about eye contact. It was just soaking. And mum was standing, both situations, both mums were observing this and listening. And I was saying to them, "You are just such a special little boy or little girl, and your mummy and daddy love you very much, and you don't need to worry because they're here, and they're at their safe place." And I said, "They love you very much, and God loves you very much." And the moment I said, "God loves you very much," the baby smiled. Oh. Now, it wasn't wind. [Laughs] But they just was... And one mum just went, "Oh, my word. Did I just see what I saw?" Because when I said it, this baby smiled. I'm not quite sure what's going on, but I think babies and young children have a far stronger spiritual awareness than we give them credit for. And I think we talk down to them too much. And I think children's talks in church can be appallingly crass because we don't give them credit that they have in terms of God's care for them. Let me give you one example of this with the Russian dolls. It wasn't me doing it, and I might slightly get the context wrong. Having painted it all, the child said to the chaplain, "So one of us is me, and one of us is God." And then they said, "Is God in me or am I in God?" because each of the Russian dolls go into one of them. What a question to ask. This is a sort of a very young child. Am I in God or is God in me? I mean, we are totally underestimating the awareness of children to the presence of God, I think.
C: It's interesting you're talking about the children's talk in church compared with what you're doing here. The thing is that the children's talk is somebody just downloading a pile of stuff, and actually what you're saying is that if we give children space, they will express what is naturally there for them, which is a very different deal, isn't it?
A: Yeah. And it's allowing them that creativity to express what's going on. So, for example, when I worked in a school, there were three year-sevens whose fathers died in the same academic year, and I did some work with them in the following academic year. And one child, I said, "Just draw if you want to, or write what you want to express." And so they drew it. They went at it with all these crayons, and they just expressed it. And I think it's giving children the space to do that, and giving them the space to be able to say, "I like this or I don't like this." And giving them the capacity to choose is a very god-like quality, capacity to choose, and to honour them and to say, "You matter." And it's not down to me to decide what you want to do or what you want to think, but to give you the space to explore it for yourself, and to explore Darth Vader's conversion from being wicked to being a goodie. I mean, how good is that? To explore “am I in God or is God in me?” To explore at the bedside, this is powerful stuff. I have in my pocket, and I usually carry around spares, a holding cross. This is a child’s version. It reminds me that I can hold onto God. Whatever’s coming my way and however bad it might be, I can hold on to God. Sometimes I don’t think I’m holding on very well. And often parents and staff can relate to that. And then I say, "A holding cross reminds me that God holds onto me." And I say, "If you'd like this, as a reminder to you that God is holding onto your child and that you can hold onto God even in the darkest time, then just take one." And I don't give it, I offer it. But if they don't want it, they can say, "No, thank you." And so I put it on the palm of my hand, palm up, and usually two or three, so they can pick one for their child and one for themselves. And very often they'll then put it into their child's hand. So you'll see, if I could take you around intensive care, you could see children with a holding cross in their hand. Or just one had, when I saw him on Friday, in between the legs of his teddy, just near his head. And at the memorial service last May, families were invited to come up with a candle with their child's name on, to light and to put near the altar. And families were coming up, and at least two, as they walked up, put their hand in their pocket and pulled out a holding cross to show me, ‘I've still got mine’. And we give away lots, I mean, seriously lots, we're always ordering them. And it's a very, very powerful reminder that what we're doing here is reminding people that the big questions at life, sometimes can't be answered, but we can hold on to God, because God's holding on to us. I can't say why their child has died, or why their child is sick, but I know God loves them and God cares for them, and that they're safe, and that their child is safe. At least two parents, two families, the mum said and the dad said, "I never believed in God, and I never prayed until my child came into hospital." They both said it. Mum said, "I just want you to pray a blessing. If I'm not there, I just want you to pray a blessing for my child." Very powerful stuff. I mean, that's why I count it a massive privilege to be here, to be allowed into this family space. But I said, "Whatever happens to your child, your child is safe." And these crosses seem very insignificant, but take on a massive thing. One family whose child died in hospital phoned to say that he'd lost his holding cross. "Could I bless another one and send him it?" So we did. Because for him, this was really important.
C: So what is it that it does for people?
A: I think it begins to answer the question that there's something much bigger than they are, much bigger than their child. That thing that's much bigger is God, who is there with their child and weeps with them, and whose heart breaks when their heart breaks, who understands their pain far better than anybody else. I can never insult them by saying, "I know what you're going through” or “I know what you're feeling”. I don't. I know what I feel, but I don't know what they feel. But God does and knows their heart and knows when it's breaking and will hold them. I sat in the chapel with a family, with my colleague, and I sat with Granddad, who was sobbing, literally sobbing because his grandchild had died. I just held him. I didn't say a word. I just held him. But God does that. God holds them and will hold them. And that's why every year they'll come to the memorial service and they'll come to the memorial picnic and they'll just celebrate their child because they've still got a son, they've still got a daughter. It's not with them, but they're still their daughter. They're still their son. And they matter. They have value. They're part of their family. And we, as a chaplaincy, want to honour them, honour those children and honour those families. And to say, "We're still with you. You're still part of the Birmingham Children's Hospital family and we'll walk with you." And some have been coming for years. They're important. And their child is important. And some of them, you know, going back far longer, I won't have known their child. Some I do. And to me, that child is still important, even though they're no longer with us. And so they've said their goodbyes to their child, but their child has said hello to God. And that hello is a big hello with a massive smile and a massive laugh and massive joy, but deep sadness this side of heaven. And that's what we're here just to bring and to offer. Not necessarily with our words, but with our presence, with our life, that this is for them. And the big thing that kind of challenges me is that they'll remember me and they'll remember my colleagues for the rest of their lives, because we were there when it really mattered. And that's a privilege. And it's also a responsibility that we've got to be open to them, actively listening to them.
C: Yes, which is where you started. That picture of holding and being held, it's a prayer that doesn't need words, isn't it?
A: I hold, I am held. And from that, it's the motto of my old theological college. That's why it's so special to me, because every time I went to college, I saw that. And it's the most profound thing that I can think of. In terms of here, when a family is going through it, it's massive. And so that's part of what I'm about, really.
C: So how has your understanding of God shifted in your time here?
A: I think it's become less verbal and much more presence-oriented. Just hang out with God, just sit a while, just spend some time, and enjoy his company, enjoy the smile, the laughter, the sheer acceptance and exuberance that he brings. So for me, to come to God and just to be in his presence and to do nothing, except be, for me, that's the most important part, really, to be. And so it's a ministry of presence. It's to be here and to let God be here, and to see what He does, see where He goes. It's not down to me.
C: Thank you very much, Andrew.
A: You're very welcome.
C: That's been great.
[music] Hope you enjoyed this episode of the Loved Called Gifted podcast. If you'd like to get in touch, you can email firstname.lastname@example.org. You can find a transcript of this podcast at lovedcalledgifted.com. And that's also the place to go if you're interested in the Loved Called Gifted course, or if you'd like to find out about spiritual direction or coaching. Thank you for listening. [music]
Editing: Stephen Dainty
Episode transcribed by Elizabeth Grosvenor