FROM VESTMENTS TO PPE: PRAYER IN A PANDEMIC HOSPITAL
Photo courtesy of author.
During that uncertain first summer of the pandemic, I was doing my first unit of CPE (Clinical Pastoral Education) by working as a chaplain at my hometown level 1 trauma center. It is always the worst day of someone’s life at the hospital, and that can rub off on the unsuspecting trainee chaplain. If I was not paying attention, I could be halfway down the hallway before I realized where I was, worrying about the patient I just visited, or thinking about which floor I needed to check in on. I was given some advice by the more veteran chaplains: whenever you use hand sanitizer or wash your hands, use those twenty seconds to center and ground yourself.
Perhaps it is incurably Anglican of me, but those wall-mounted hand sanitizers became my hospital holy water stoups. The hallway sinks became lavabo bowls. I found myself almost automatically adapting prayers and rituals around hand washing. “As my hands are sanitized, so purify my spirit for this chaplain visit.” Taking that hand-sanitizer moment to orient myself spiritually is crucial to being present as a chaplain. I wash my hands every time I walk into or out of a room in the hospital. Every time I wash my hands, it reminds me of God’s presence and reorients my spirit and intentions towards God. I wash my hands for my physical wellbeing, of course, but allegorizing a spiritual meaning makes it good for my spirit, too. Praying while washing my hands intertwines physical and spiritual preparation. The hospital is cold and isolating out of physical, medical necessity. Twenty seconds of prayer at the hand-sanitizer dispenser will not overcome that, but it does create a sacred space for a moment.
I returned to that hospital in September 2021 to begin a one-year CPE residency, right at the Delta wave of the pandemic. Then Omicron hit. Some weeks it felt like half the rooms had Covid patients, and everyone was short staffed because of illness or quarantine. We were wearing N95 masks even in the hallways and nursing stations, and the precautions were constantly changing as we learned new best practices. Things were disorienting and full of anxiety even for the experienced staff. The medical field tends to focus on the quantitative, on solving physical problems with measuring and monitoring. So much is clinically inhumane, treating people as data, not souls. The medical machine thunders along, seemingly oblivious to the isolation and anxiety that are the side effect of the effort to preserve lives. The hospital intends to do an excellent job treating a patient’s physical body; spiritual health is something that can be addressed only after the physical is taken care of.
Nurses, cleaning staff, the people rushing to make sure everyone has their food while it is still hot, everyone at the hospital is always in a hurry to complete their tasks. In these pandemic times, perhaps the one time someone stands still is while they are “gowning up” with PPE to go into a patient room. So, I turned that physically protective practice into a spiritually productive one. I drew on the tradition of the vesting prayers used to prepare for a church service. When I put on my PPE, it is like putting on vestments. As I put on gloves, I prayed that my hands would be a source of connection and comfort. When I put on my N95 mask, I prayed that my words would be loving. A hospital room and a church sanctuary are physically very different, but they can both be sacred and holy. In the midst of the perils of working in a hospital, I turned to the traditions that have always helped me. There is no need to reinvent the wheel when the church has already fine-tuned these things over the centuries. The beauty of participating in my Anglican liturgical tradition even while in the hospital is that there is no separating the physical actions and spiritual intention. We do the physical things because they need to get done, but each action also has an essential spiritual meaning.
This connection between the physical and spiritual is by no means unintentional in our faith. Vesting prayers appear to have their origin in making exactly this connection between the physical form of the articles of clothing and the spiritual virtues of a minister. Maureen Miller describes the context that led to the tradition of vesting prayers in her book Clothing the Clergy. (1) Clergy in the early medieval period learned the mechanics of priesthood through apprenticeship. There was not much theological training in the way we think about it today. There were definitely theologians, and people who thought deeply and believed truly, but for many locally-trained clergy, it was more important to first learn the practical matter of performing liturgy. Maintaining the liturgies of the church, that is, doing the physical, visible work, was the primary concern.
Vesting prayers were a way of making the theological connections between the physical work and the spiritual work. (2) Clergy in this period could be incredibly spiritual and virtuous, but there were also clergy who saw no contradiction between the spiritual virtues they preached and the physical vices they practiced. (3) The composition of vesting prayers to be used while preparing to celebrate the eucharist was one of the liturgical reforms of the Carolingian period that was intended to tackle this problem. Early examples have a single prayer, perhaps for when the priest puts on the chasuble or stole. (4) Eventually, each article of clothing had its own prayer, invoking some virtue that clergy were expected to uphold (e.g. cleanliness with the alb, chastity with the cincture). (5) Each time the clergy put on their vestments, they would be meditating on those virtues. Each prayer was an appeal to God for those virtues. Each vestment was a physical reminder of those prayers. The physical and spiritual were intertwined.
In the same way, my PPE prayer practice intertwined the physical preparation with the spiritual. I was preparing physically by protecting my body from infection. I was preparing spiritually by invoking the virtues I wanted to carry into that chaplain visit. And like the Carolingian reformers, I shared this prayer practice so that others could also make that connection between the physical and the spiritual. There was such a yearning for some way to make meaning out of the senseless tragedy of the pandemic. The grueling pace of endless tasks needed to be interrupted, if only for a moment of focus and intentionality while checking the seal on a respirator. The story of exactly how my private devotion of PPE vesting prayers became a shared practice among hospital staff involves too much corporate bureaucracy to be interesting. The important change was that the specifically Christian language became spiritually interfaith. The chaplain department printed cards to distribute with the words:
A blessing for PPE
While putting on mask or respirator
May my breath be a source of life
and my words be a source of love.
While putting on goggles or face shield
May my eyes see clearly
and my mind perceive with compassion.
While washing or sanitizing hands
May my hands be cleansed for healing
and my spirit be purified for comforting.
While putting on gown
May my body be fully present
and my strength be steadfast.
While putting on gloves
May my hands be gentle
and my heart be peaceful.
My intention with this was to create a little breathing room in the midst of a relentless day. Most people hurry through putting on their PPE so that they can get on with their tasks of caring for people’s physical needs. These short prayers do not take any more time, but they add meaning to the tasks that we repeat so often in our care for patients. The PPE is important for preventing the spread of disease, but it is also annoying and awkward and can sometimes feel pointless when we wear the gown and gloves for just 3 minutes before leaving the room again. As we prepare our bodies to physically enter a room, we can also prepare our hearts and minds with intention and focus. It is hard to focus on the spiritual in a hospital. Hospital rooms might be some of the aesthetically least-pleasing spaces, with all their sterility and fluorescent lights. The gowns and gloves and goggles create another layer of separation and isolation between patients and everything else. It is no wonder that the spiritual is left to one side in an attempt to get people through the hospital treatment as quickly as physically possible.
However, our PPE can also be imbued with spiritual meaning. When I put on a plasticky isolation gown, I remember the presence that my body has in the patient’s room. The physical presence of the PPE reminds me of the spiritual virtues in my prayers. As I pray that I am fully present, my focus and intention makes that presence happen. Hospital rooms are not intrinsically set aside to be holy, but we can make them holy through our time and presence.
The “contact precaution” rooms are some of the most isolated and lonely rooms in the hospital. Staff need to wear extra PPE, and are instructed to spend as few minutes as possible in those rooms. These rooms can become particularly holy as we prepare to enter safely with PPE, taking those moments of physical preparation to prepare spiritually. We prepare to enter each hospital room with as much care as a priest preparing for a church service. We don PPE in order to prepare physically. We prepare spiritually in order to carve out a sacred and holy space in the midst of a hospital. As we intertwine the physical and the spiritual with our intentions and prayers, each hospital room becomes a sanctuary.
Miller, Maureen C. (2014). Clothing the Clergy: virtue and power in medieval Europe; c. 800-1200. Cornell University Press, 51-95.
Pierce, Joanne M. (1996). Early medieval vesting prayers in the "Ordo missae" of Sigebert of Minden (1022-1036). Rule of prayer, rule of faith Essays in Honor of Aidan Kavanagh, O.S.B. Liturgical Press, 80-105.
Miller, Clothing the Clergy, 86.
Ibid., 84.
Pierce, “Early medieval vesting prayers”, 88.
