Friday, April 14, 2023

Nate Hood ponders A STILL SMALL VOICE (2023) Hot Docs 2023


When I saw A STILL SMALL VOICE at Sundance I knew I had to get Nate Hood to see the film. Nate is currently studying to be a hospital chaplain and I wanted to get his thoughts on the film. How better to judge a film than a man living the events depicted?  I managed to get him to see the film and he was blown away by the film. 

Because of the way things fell and a class schedule Nate was only just able to turn in a review.  With the film playing soon at Hot Docs I'm presenting Nate's piece 

In his 1987 film Wings of Desire, director Wim Wenders imagines a Cold War Berlin inhabited by angels. These angels, invisible and incorporate to the humans among them, have watched over the city eons before it was even a city. They serve not as guardians, but as observers, eternal witnesses to the humans around them, privy to their innermost thoughts and feelings. In one heartbreaking scene, one of the angels named Cassiel (Otto Sander) watches helplessly as a young man commits suicide, hearing his every thought, sharing his every agony. The angel, sitting beside him until the last—head on his shoulder, hand on his back—howls in impotent, unheard agony as the young man falls out of his grasp off the side of a tall building.

I used to think that no other moment in film better captured my experiences as a hospital chaplain than this one. Coming from every walk of life and faith tradition, we chaplains aren’t called to heal or even intervene in the lives of our patients. There are doctors, therapists, and lawyers for that. When we enter the rooms of the sick, the dead, and the dying, we do so knowing we will ultimately be as helpless as Cassiel to save them. Though I’ve only completed one of the two necessary residencies to become a board-certified chaplain, I’ve already seen more than my share of death. I’ve prayed over the bodies of braindead car accident victims on life-support. I’ve held strangers in my arms as they shrieked and wailed mere feet from where their loved ones were actively coding. I’ve looked husbands, wives, sons, and daughters in the eyes as they learned those closest to them in this life have slipped away into the next. All I could do—all we chaplains can do—is be present in the moment and offer what religious help we can. We are there, like Wenders’ angels, to look, listen, and bear witness to the suffering humanity around us. We walk beside our patients in their pain, help them acknowledge their thoughts and feelings, and provide company when there is no other company to be had. Sometimes we talk about God. But most often, in my experience, we don’t. And that’s okay.

Not all chaplains are Christian, but I am, and in my tradition we call this work a “ministry of presence.” Though some might reject this as superstitious nonsense, it’s no snake oil pseudoscience. A landmark, oft-cited 2014 study in the Journal of Palliative Medicine proved that hospital spiritual care both improves recovery rates and patient quality of life. Our work is necessary and transformative. But it’s hard. It exhausts the body and mind. It’s heartbreaking, soul-wearying work. And what’s worse, there aren’t enough of us to go around. In 2019, more than one-third of American hospitals didn’t have chaplains on their staff. Now, four years later, I can only imagine how our ranks must have been further diminished by COVID-19. (I caught the disease myself for the first time while working with COVID patients. Despite being young, relatively health, and triple-vaccinated, the disease incapacitated me for nearly a week.)

But now, a new documentary has arrived which supplants Wings of Desire as the most honest depiction of what hospital chaplaincy work feels like: Luke Lorentzen’s A Still Small Voice. The film follows 150 days in the life of Margaret (Mati) Engel as she nears the end of her chaplaincy residency program at The Mount Sinai Hospital in New York City. Filmed amid the COVID-19 pandemic, the film accompanies Mati as she visits patients, participates in group discussions with members of her residency cohort, and reflects upon the stresses of her work. A third generation Holocaust survivor, Engel never shies away from her conflicted feelings about God as a practicing Jew. She’s open with her colleagues and patients about her difficulties having what she calls an “adult relationship with the divine.” She quotes a prayer from Maimonides one moment only to question the idea of an “imminent God” the next. 

Not that this disqualifies her from chaplaincy. Quite the opposite, in fact. I can testify from my own experience that patients more often than not want and appreciate honesty about our convictions and doubts about God. This is evidenced in one powerful scene in the film where Mati talks with a bereaved family member of a recently deceased patient over the phone. When they ask her what Jews believe about life after death, she answers that she can only speak from her own experience. Quite simply, she doesn’t know. She admits that death is scary. But she explains that she believes that “when a soul is finished with its work…death is okay.” And though we can’t see the relative’s face, we can hear the relief and reassurance in her voice over the phone.

Lorentzen’s last film Midnight Family (2019) likewise examined people working on the fringes of an overworked healthcare system, following a family of paramedics operating a private ambulance service in Mexico City. As in that film, Lorentzen spends relatively little time focusing on things audiences might find “exciting.” There are no breathless sprints to flatlining patients, no dramatic bedside conversions, no interviews with patients sporting grotesque injuries or exotic diseases. The one exception is a scene where Mati blows up at her supervisor after he confronts her for showing up several hours late for a shift without properly notifying anyone. But even this confrontation, though painful, is brief and quickly moved on from. As with Midnight Family, Lorentzen is more interested in the job’s less glamorous moments of stillness and sheer, full-bodied exhaustion. Many of the shots see Mati leaning against the walls of empty hallways, sprawling on the bed in what I assume to be either her apartment or her hospital’s on-call suite, or sitting in silent reflection in group meetings. Personally, I’m glad Lorentzen took this approach; any attempt to glamorize what we do or ignore the toll it takes would be disingenuous.

Wenders’ Wings of Desire ends with Damiel (Bruno Ganz), one of Berlin’s angels, rejecting his immortality and becoming human. The end of A Still Small Voice reveals that Mati, too, left hospital chaplaincy after completing her residency. She now, ironically enough, lives in Cassiel and Damiel’s home city of Berlin, working as a “performance artist, theologian and spiritual care practitioner.” All I can say is that I understand and wish her well. Our profession can be a meatgrinder that leaves nobody, even the ones who stick around, unscathed. So why do we do it? I think Mati herself inadvertently answers this question in the film when she admits that religion
can be used as a “psychological crutch” some people use instead of confronting reality. “But then,” she continues, “at the same time I can’t throw all of this out because there’s too much here that is nourishing.” Nourishing for her patients? Or somehow, I wonder, nourishing for her as well? I have my suspicions. And I think anyone else who watches this magnificent film will have them, too.

 1. Puchalski, Christina M et al. “Improving the spiritual dimension of whole person care: reaching national and international consensus.” Journal of palliative medicine vol. 17,6 (2014): 642-56. doi:10.1089/jpm.2014.9427
 2. Abrams, Amanda. “Hospital Chaplains Stick to the Heart of the Job amid Health Care Industry Changes.” Religion News Service, May 31, 2019.
3. Engel, Mati. Mati Esther Engel. Accessed April 12, 2023.

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