It had taken me a long time to get through Frank’s* door. He had cared for his brother at his home until his symptoms became unmanageable and he had to go to a skilled nursing facility. He wasn’t on service for long though, as after his admission he died within a short time. Prior to this, we hadn’t had much contact with Frank. He wasn’t making medical decisions for his brother, and he often came across as gruff and reserved over the phone. He had declined a chaplain for support as well as our social worker. However, after the death our staff raised concerns about Frank, given how close he and his brother were and his own health problems.

Frank was a military veteran, though at first he never talked about his service. He seemed very closed off and formal at first, giving me the answers he knew I wanted to hear. It became apparent with time that this was his way of keeping the pain of his prior service, as well as his inner personal and spiritual struggles, at bay.

I initially started calling Frank for bereavement support but found I couldn’t get very far. He was reluctant to talk at first, usually giving the worn-down “I’m doing as well as can be expected” answer regarding how he personally was doing. As time went on, he did begin to open up about his feelings of loss, depression, and a questioning as to why he was still alive. While initially I had thought that Frank would probably grieve normally, it became clear that he was not doing well. His health was fairly poor, he had very little support, and was quite lonely. He struggled with PTSD symptoms from his time in the military. He could find no meaning and purpose in his life. While he continued to pray, he felt angry at God for what he had gone through and what he had seen others go through. He told me on more than one occasion that the only thing keeping him going was his beloved German Shepherd, Cleo.

As these feelings started to surface, I encouraged him to talk with a counselor at the VA. After much encouragement he did, adding that he was cautious because he didn’t “want to get 302’d [involuntarily committed]”. Unfortunately this didn’t go very well. After the first session he quit, telling me that the therapist had looked at her watch once too often and didn’t seem interested in what he had to say. I had been reluctant to offer a visit as Frank seemed intent on pushing everyone away from him. I also felt uncertain about his acceptance of me either as a chaplain or a counselor one-on-one. We had talked over the phone for almost a year, and I felt I wasn’t making much headway. I made the offer anyway, and he hesitantly accepted.

Before I met Frank I was met with a sign by his front door saying “nothing in here is worth your life” with a picture of a gun. Frank himself was built like a barrel, short and stocky, still with his military haircut. At our first visit he was very emotional, often tearful and occasionally angry. We talked for well over an hour, mostly about his time in the service as well as his time as a rescue diver. These had taken a significant physical, spiritual and emotional toll on him. He spoke at length of his time in Vietnam and the horrors he saw there, as well as friends he had lost there and afterward. He carried a lot of regret and guilt due to his wartime activity. After the service he became a rescuer with the local fire department and while he had made some newsworthy rescues, he was always haunted by recovering a drowned child in a river. In his home you saw mementos such as newspaper clippings and photos with local leaders, yet still this one incident overshadowed all the others.

Also on the wall was a picture of Jesus. It was a common Catholic representation of Jesus showing his heart to the viewer, arms outstretched. Frank talked about his faith, which remained strong in spite of all he experienced and continued to experience. He would often well up with tears as he talked about his prayer life. He told me, “Every day and every night I get on my knees and thank God that I’m alive, that I made it through another day, and for Cleo. No matter how hard it is for me, I get on my knees.” While his faith remained strong, he didn’t feel at home in church and would occasionally vent his anger at it as well.

I couldn’t help but feel overwhelmed at the weight that Frank was carrying and didn’t really know how I could help him carry it. The things that I typically would fall back on as recommendations in similar situations, such as counseling and medication, had already been ruled out by him and I didn’t feel like I could bring them up again.

During our next few visits, we talked a lot about his faith, especially the guilt he felt. I counseled as best I could, always remembering to listen and, in a phrase borrowed from Proverbs, not to sing songs to a heavy heart. Frank’s emotions were raw and open, and he would not be helped by spiritual fluff – or psychological fluff for that matter. I listened and we prayed at the end of each visit. Each time we prayed, he would weep and almost crush my hand in his. I was seeing that he was one who so desperately wanted God to hear him, and yet always wondered if He did. Our prayers together gave him a sense that God did hear him and cared for him, which was something he needed desperately.

One day during one of our visits the phone rang. He picked it up and talked for a few seconds, but then said, “I can’t talk right now, my pastor’s here.” I was a bit taken aback by this, in the best possible way. I had been trying to navigate a number of different roles in our relationship for well over a year by this point. Was I a bereavement counselor, a chaplain, a friend, or a therapist? Frank, however, gave me my ordination: I was his pastor.

As time went on Frank slowly improved across the board. His health improved and he started taking better care of himself. He connected more with friends. While he didn’t address it verbally, I could see that the guilt which he had carried was starting to lift. He smiled and laughed more. He still struggled with loss tremendously, and almost every visit he told me of another friend from the Marines or the rescue unit who had died. He missed his brother tremendously, but it wasn’t as painful as it had been. His son, whom he had been somewhat estranged from, moved in with him and the two now had a much better relationship.

Typically in hospice we offer to follow folks for a year for bereavement. Most of the time that’s plenty, and some don’t even feel the need for that. With Frank though it had taken a year just to get the point where we could talk about his grief. As the end of a second year approached, I struggled with what to do next. He had definitely improved, but still had a long way to go. I worried that ending at this point could trigger abandonment issues, yet I didn’t know what else I could do for him as a bereavement counselor. I brought this up to the CPSP group that I’m a part of to get their feedback. “Sam, you’re his pastor,” they said, “He gave you that title, and that’s what you are.”

Frank needed a pastor, and I could choose to continue be his pastor. This thought was tremendously freeing for me, as it moved me out of a clinical role and mindset, with all of its care plans and billing codes, to one that was simpler and yet more profound. I had been ordained previously, on two occasions actually. Once was my first call out of seminary, and that turned out to be a bit of a disaster. “Pastor” there was merely a job title. The second time was after I was ordained by my local church where I am a member. That time was so I could carry on in my role as Chaplain. While that certainly felt more meaningful, it still wasn’t something that I identified with. Yet this third ordination by Frank has proven to be the most significant and meaningful for me. We still talk and visit routinely, and I appreciate how he has grown in faith and purpose through our interaction. Moreso, I appreciate how I’ve grown in a similar way.

*names and details have been changed to preserve confidentiality