The Rev. William Spacek was headed home after a full day’s work as a Catholic chaplain when he got an urgent call from one of the hospitals he serves, the University of Maryland Baltimore Washington Medical Center in Glen Burnie.
A patient in her 80s was dying of COVID-19, the illness caused by the new coronavirus. The woman’s daughter wanted her “to be prayed with.” The 57-year-old priest drove to the hospital and found the floor where she was being cared for.
But where he would normally have sat at her bedside, he stayed in the hall, watching her through a glass door. Where he’d normally have anointed her forehead with oil, he read her a prayer by phone, a nurse inside holding a receiver to the patient’s ear.
The nurse later told him that the unconscious woman’s blood pressure, which had been high for days, steadily lowered as he prayed.
A patient who would have died alone had been comforted, suggesting to Spacek that he had fulfilled his mission, especially in the time of COVID-19.
“Patients are not allowed to have their families with them, so we must be there at these moments," says Spacek, now in his 22nd year as a hospital chaplain. “It’s at times like this that chaplaincy is most important.”
As the coronavirus continues its jaw-dropping spread around the world and across the country, its murky origins, unknown mortality rates and unknowable final economic toll are not all that is sparking fear.
To some, what’s most frightening is that when virus does become lethal, its victims are dying in isolation, without the company and support of those they love and who love them.
Catholicism is far from the only faith tradition that incorporates rites meant to offer blessing or comfort when the end is near, and some call for friends and loved ones to be present.
But the essential Roman Catholic rite around death, the Anointing of the Sick, calls for the priest to be physically close to the ailing person, and for physical touch in the laying-on of hands and application of consecrated oil.
In other words, the rite — one of the church’s seven sacraments — includes two of the very forms of interaction health officials have banned until further notice, forcing Catholic clergy out of their comfort zones.
Local priests used to doing rounds in hospitals are conferring with the terminally ill by phone. Others are offering blessings from hallways, behind closed doors.
Most hospitals, nursing homes and hospice centers have banned or curtailed in-person visits by anyone not directly involved in providing medical care. Chaplains in some cases are able to enter a patient’s room, but not always.
The pandemic has left many clergy in a perpetual state of on call, ready to drop in on the severely sick on short notice. Chaplains must check in at hospital entrances, undergo temperature tests, don masks and gloves and, in some cases, ask for the N95 masks that hospitals are trying to keep for front-line medical workers.
“This pandemic hasn’t changed my thoughts about my role in the ministry, but it has meant so much radical change it’s almost surreal,” says the Rev. Tom Malia, a Baltimore priest who helps lead the Office of Mission Services at Mercy Medical Center, which helps administer Catholic sacraments. “All of a sudden, everything you’ve depended on for 35 years is out the window.”
At Mercy, where elective surgeries and other nonurgent procedures have been cancelled, the hallways are empty, Malia says, creating an eerie feeling. And while morale among those who are present is good, it’s strange to be required to seek permission from a command center just to be able to visit a patient.
Last week, he responded to a plea from one of the hospital’s five chaplains to administer the Anointing of the Sick to an elderly woman who is seriously ill, although not with coronavirus.
The woman’s husband, Malia was told, was distraught that the no-visitor policy — the current standard for hospitals — barred him from being with her.
He understood the need for the restrictions, Malia says, but still had a profound need for reassurance.
The sacrament was to be as much for his benefit as for hers.
“Because I couldn’t touch the patient, the chaplain and I said a prayer of healing over her,” Malia says. “I used the foundation of this prayer as scripted, but I made it more specific to the occasion, including blessings for her care providers and special care for her husband.”
The ritual wasn’t done by the book, but how it happened left Malia focused on a silver lining.
“The rites are very important in ordinary times, but these are not ordinary times," he says. “If for very good reasons we can’t perform them, it forces us to ask, ‘What are we really trying to do? Perform a rite, or connect people with their family, their church?’"
"We’re being asked to get to the bottom of what the sacrament really is.”
Across the region, priests are doing so within a framework of new rules from each healthcare facility, as well as from the church.
Guidelines the archdiocese issued this month — developed with health officials, the Vatican, the U.S. Conference of Catholic Bishops and the Code of Canon Law ― stipulate, for example, that it’s permissible for priests to anoint a person on any part of the body. It’s OK now to use a gloved hand, a cotton ball or a cotton swab in doing so.
While some priests may be comfortable using that approach, Spacek says that in cases of patients who are close to death, he’s going to "the back of the book.”
He has been consulting a less well known portion of the book of rites known as “Pastoral Care of the Sick” to employ an ancient indulgence known as an “apostolic pardon.”
This spoken rite grants the remission of sins for the sick or the dying. That, he says, beats using rubber gloves. It’s also safer for the priest and everyone he comes in contact with.
“I think you’re better off standing outside the door and saying the apostolic pardon,” he says.
Even as they develop solutions, though, area priests are encountering frustration and heartbreak.
The Rev. Samuel Young, a chaplain at Greater Baltimore Medical Center and Gilchrist Hospice Center, says increasingly strict restrictions are coming thick and fast.
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Asked to perform the Anointing of the Sick for an elderly woman at Gilchrist, Young donned the gloves, mask and gown required and carried out the rite in person as the resident’s daughter, similarly garbed, livestreamed the proceedings to family members via Zoom on her iPad.
The daughter’s livestreaming allowed for at least a facsimile of a gathering of loved ones, which hospice workers say can be important to a positive end-of-life experience.
Soon after, Gilchrist like some other health facilities barred all visitors to inpatients.
“It’s necessary at a time like this, but the spiritual loss is painful to think about," he says.
Now allowed just one non-emergency visit per week, Young uses it to visit the campus, where he places phone calls from an office to the 25 residents he is charged with serving.
The fact that he’s not only reaching out to them, but doing so from somewhere on the grounds, appears to be bringing solace to their solitude.
“People are understanding” of the limitations, he says. “I have not had one person demand that I offer something I can’t. We all know the rites are important, but right now, what I’m seeing is that people are very appreciative of our presence.”