As one of six hospital chaplains at St Luke’s, Fr Mario Attard offers pastoral care to patients on a shift basis. He spoke to Carla Gatt on grief counselling and on providing empathy and compassion to patients, their relatives and even the staff at St Luke’s.

How did you start going on pastoral visits to the hospital?

My sister was diagnosed with cancer a few years ago and she requested that I accompany her to the Royal Marsden hospital in England. After seeing the support I offered to my sister and seeing me converse with other patients, the Father provincial there pleaded with me to continue this work at St Luke’s hospital in Malta. He sent me the warrant and I started working at St Luke’s on 6 September 2004.

I have also followed programmes on Clinical Education in Australia in 2005 and between 2006 and 2007. It is important to underline that pastoral care is not based on the Catholic religion, most of it is based on psychology. Pastoral care is non-denominational. Anyone with a warrant can give pastoral care, no matter what his religious beliefs are.

How do you offer pastoral care?

I go around the hospital and respond to the needs of certain situations. Pastoral care is when you offer compassionate presence through warmth, empathy and listening. Showing availability to the patients and their relatives is of essential importance and this is mainly done by manifesting my presence. Patients and their relatives then feel that they can open up and talk about what they are going through and a relationship between us is then established. I believe that every life story is sacred and listening to the story and validating it is very important for the healing process to occur.

Reflection is also a vital aspect of this process. It is simply not enough to carry out the work. I always need to reflect on what I could have done differently that could have improved the situation faster or maybe better. I think this is relative to any job out there not just mine. I always need to assess my service and how I can improve it.

Has there ever been a situation where one of the patients or relatives refused to acknowledge your support because they hadn’t yet accepted their condition or because they didn’t want to talk to a representative of the Catholic faith? How did you deal with it?

That never happened to me in Malta. However, it happened to me in Australia. In this case what happened was that I still went around and showed my availability to the patient even by simply saying “hello”. After three or four visits, the patient opened up. The best means is to show persistence in a loving way without imposing religious beliefs in any manner.

How do children in the Karen Grech unit react to your presence?

Whenever I go to the Wonderland or Disneyland wards I usually let the parents speak and express their feelings. My work focuses mainly on adults although I’m obviously never going to turn a child away when she or he needs me. With children, as they say, I dance with the music and if they want me to join them in a game, I do so without hesitation. In a recent case with a five-year old girl who was diagnosed with a brain tumour, the parents felt my compassion and support each time they saw me blessing her by putting a cross on her head with consecrated ointment and praying with her. In cases involving children, more empathy in the form of mirroring is usually needed.

Could you elaborate further on what “mirroring” actually entails?

Every grief-stricken person has their own history and I have to be interested in learning that history. I do this with no hidden agenda. The response provided with regard to mirroring is extremely delicate as I have to project a certain voice pitch and be cautious even with the gestures I make. I have to be where the person is at and through empathy, I have to help that person realise their own hidden potential.

When people first start to open up, it is as if the world is crumbling down on them but further on during and after the healing process, they start freeing themselves and are better able to deal with the situation. It feels truly satisfying to hear the patients or the patients’ relatives saying that they need to converse with some relative of theirs or talking about certain memories they shared. They have to feel liberated. I always keep St John’s biblical quote in my head at the start of this process: “I came that you may have life and have it abundantly.” (John 10:10)

The grief of relatives must affect you and even the staff at St Luke’s. How do you look after yourselves in order not to suffer from burn-out?

I always see the role of chaplain as a sacred haven for the hospital. The chaplain reinvigorates the staff and helps them to acquire the courage to continue carrying out their duty. When an 18-year-old youth passed away in hospital recently, some of the staff in charge felt very discouraged, and they needed to unload their feelings. I took them under my wing and after listening to them, I invited them to pray together. My relationship with the staff, especially the nurses, is very important for the patients’ sake as they would always know which patients need most attention and comforting.

As to self-care, I usually follow spiritual direction, and ensure that I dedicate some time to my hobbies, such as reading and going for walks every day. The people surrounding me are also very important and I have to ensure that I have very healthy relationships and sound friendships with those around me. I also call on my Australian pastoral supervisor at times to discuss my work and to hear her feedback.

How have you dealt with situations where the patients and their relatives are so irate with God, they refuse to resort to prayer?

I’ve had situations where couples struggle for years to have a child together and then give birth to a baby with internal malfunctions. In these cases you can do nothing but accept their grief by validating their anger. In this context, even though I am a priest I must acknowledge the fact that for the healing process to start I must confirm the couple’s anger. They will eventually come to but I can never push it.

When those five boys from Qrendi passed away two years ago, I was the chaplain in charge. The waiting room was vacated and it was up to me to offer my compassion and presence to their families. When patients are not in a position to pray because their grief and despair are too strong, I remain silent and just act. In the case of those five boys, I just offered coffee to their families, handed them paper handkerchiefs and held their hand or patted them on the shoulder to let them know that there was another physical and spiritual presence among them.

Co-dependence and dependent personality disorder are two psychological disturbances which can arise after pastoral care is provided. How do you prevent this from occurring?

I am only bound to carry out my duty inside St Luke’s and I cannot bestow pastoral wisdom outside the hospital premises. When patients or their relatives express the wish for me to continue to provide my services to them outside St Luke’s, I explain to them that my work is limited to care inside St Luke’s only. I always have to address the most urgent needs and sometimes I admit that it is difficult to cope, especially when there are a number of cases which require this kind of care simultaneously.

How do you support the families when you are about to administer the last rites to the patients?

It is important that first the relatives would have expressed their emotions and established a relationship with me whereby they feel that they really trust me. It is from then on that I administer the last sacraments to the patient.

When such a relationship is established, the patient becomes the teacher and the priest becomes the student and I can only learn from the patient with regard to what he requires and needs from me in such a situation. Consequently, if the patient refuses to receive the last sacraments, I will not administer them.