Reverend Gloria White-Hammond wasn’t sure what to expect.
How many members of the Bethel African Methodist Episcopal (AME) Church in Jamaica Plain (a neighborhood of Boston) would want to spend their evening talking about their end-of-life care wishes?
White-Hammond recalls, “I anticipated that we might get 10, maybe 20 people” for the first Conversation Project workshop. To her surprise, over 40 people attended. Even now, after two years, “people who didn’t join the first go around are starting to come as they’ve heard about it or as circumstances in their lives have changed.”
The ordained minister and pediatrician has found her congregation’s embrace of The Conversation Project Starter Kit and the Five Wishes advance care directive heartening. Discussing death and dying with her community has given Reverend White-Hammond a unique opportunity to use her experience as both a faith leader and physician.
“Given that I wear both of these hats,” Reverend White-Hammond says, “I think part of my job is to break down whatever sense of dichotomy there is between medicine and spirituality.”
“It’s not body versus spirit. It’s life.”
Both sides of the bed
For almost 30 years, she was Doctor White-Hammond. But 20 years ago, she felt drawn to another vocation. Though White-Hammond enjoyed being a pediatrician, she “had a real sense that there was another bit of work that I was called to do.” She went through seminary and got ordained, and continued to practice medicine while co-pastoring with her husband, Reverend Ray Hammond.
From her earliest days as a medical resident, patients sensed her willingness to talk about spiritual matters. “People would often feel very comfortable talking with me,” she recounts.
White-Hammond’s medical peers, however, rarely seemed to share her openness about religion or spirituality. “I learned during my medical school days [that I was supposed] to check that stuff at the door,” she says. “Yet I was keenly aware that that’s what many of my patients were thinking about.”
White-Hammond sees similarities between medicine and spirituality, especially as medicine becomes more patient-centered and more practitioners approach health care as a collaboration with patients. “The sense that we’re in this together,” she notes, “is the most rewarding and humbling aspect of both medicine and ministry.”
“Much of my work now,” she says, “is helping clinicians think and talk about spirituality.” Clinicians need not share the beliefs of their patients, White-Hammond says, but must respect them, particularly during a crisis.
“I can tell you from being on both sides of the bed, if you will, of the sick patient,” she notes, “that there has often been misunderstanding and mistrust” between a clergy member and the patient’s medical providers. This puts additional stress on already taxed patients and families.
“What we need to do,” White-Hammond says, “is create a space where we can talk — each one of us fulfilling our roles — and learn how we can come together to support the person we all care about.”
Reverend White-Hammond also uses her position as both an African American pastor and physician to help bridge another often unspoken divide. With a history of medical exploitation including the Tuskegee Study and the racism and health disparities that persist to this day, “the suspicion that many African Americans have with regard to the medical system remains robust,” White-Hammond says. Add this to the fraught experience of advanced or terminal illness, and African American patients and their families can sometimes view “comfort measures only,” for example, as withholding treatment.
White-Hammond addresses these misgivings during Conversation Project workshops. “My role as both a medical provider and pastoral leader is to facilitate those discussions,” she says.
Having seen families choose ventilators or risky surgeries as demonstrations of love or religious faith when they had little chance of improving a patient’s quality of life, White-Hammond advocates early discussions about end-of-life care wishes. “God can work miracles,” she says, but faith should not mean choosing treatment that only prolongs anguish and goes against a patient’s bidding. “If the person didn’t want to suffer in a certain way, we should ensure that they don’t suffer in that way,” she says.
Changing the culture
“The blessing of the Conversation Project is that we have begun to normalize [end-of-life] discussions,” White-Hammond says. “It’s starting to change the culture.”
People come to Conversation Project workshops with circumstances as different as a young couple expecting a baby, and a gentleman with a seriously ill sister. “He recognized that, in order to support her, he’s got to do some of this work for himself,” White-Hammond explained. Another church member’s father died unexpectedly, and he said: “I want to do this differently.”
“Studies have shown that many people — including African Americans — appreciate having [end-of-life] conversations in their churches,” White-Hammond notes. “We’re giving people tools, questions they can pose, and ways of thinking about it that makes the conversation easier.”
“The Conversation Project work we do is helping people talk about their end-of-life concerns from a spiritual perspective. I think it’s a gift that people are ready to embrace.”