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Hospitality in the Midst of Crisis: A Guide for Showing up in Suffering—Kate Gaston


by Kate Gaston


Fresh out of my graduate training as a physician assistant, I accepted a position at a Level 1 Trauma and Burn ICU in a large university hospital in Birmingham, Alabama.


I’d spend the next eight years of my life working there. Its hallways, nooks, and crannies became second nature to me. I knew which nurses’ stations served the best coffee at any hour of the day. I knew which supply closets housed the stashes of graham crackers and peanut butter. Each morning at 5:00 a.m., I’d sleepwalk from the parking deck to my unit, catching glimpses of the rising sun through waiting room windows.


Our surgery cases began promptly at 7:00 a.m. Once we had our patient on the table, sleeping that dreamless sleep of the anesthetized, we’d crank the music and get to work. The energy of a well-run operating room is galvanizing, and I fell in love with burn surgery during my very first skin-grafting case. Burn surgery is not complicated, but it is creative. It’s like quilting. Except you’re using human flesh instead of fabric. I was hooked.


I’d spend the rest of my work days walking the halls of the twenty-eight-bed ICU, eyes peeled for those subtle trends that might foretell impending crisis for our critically ill patients. In the moments when the unit was quiet except for the beeping of monitors and the machine-hum of ventilators, I’d finally sit down to eat my lunch. I might have just taken my first bite of a sandwich when the guy in bed seventeen would start coding. One moment he was fine. The next moment, he’s actively trying to go to the light. I might still be chewing on that bite of sandwich while scrambling on top of him to initiate CPR.


Some days were marred by biting loss—unexpected reversals, heroic measures all for naught, lives snuffed out too soon. I also bore witness to incredible—dare I say miraculous?—recoveries, the kind of stuff that makes you believe there’s a God.


I loved the blood, the guts, the adrenaline. I loved the battlefield glory of the blood-soaked operating room. I loved being part of a team that worked together to support patients through the worst moments of their lives.


Usually, due to the severity of their injuries, my patients wouldn’t ever know I was there. They were kept in the dim shadow world of unconsciousness by the steady dripping of carefully titrated anesthetics. This was precisely as it should be. No one should be consciously aware of the many medically necessary things done to the human body in the case of acute trauma.


Often, the families and friends of my patients wouldn’t realize I was there either. This was a different kind of unconsciousness. During those initial post-trauma hours, the patient’s loved ones exist in a hazy bewilderment, a wide-eyed, half-reality.


Those people closest to the patient are forced to undergo a violently abrupt recalibration.


Someone they love, who only hours ago was texting about the grocery list and making plans for dinner, is now lying on a hospital bed, with tubes emerging from their mouth and nose. A monitor shows the spiking beats of their heart. A machine forces air into their lungs, causing their chest to rise and fall in eerie, inhuman precision. That body, once so familiar, so intimate, has become an alien thing. Where once there existed a blithe sense of immortality, now the specter of death is so immediate, so palpable, he might as well be sitting in the corner, twiddling his thumbs.


What, exactly, does hospitality look like in the context of acute suffering?


For those closest to the crisis—be it a physical, emotional, or spiritual crisis—the concept of “business as usual” ceases to exist. In this new, altered reality, the needs of their body become an abstraction. They forget to feel hunger. They forget to feel thirst. There is no space left for such concerns. They must reorganize every perception of existence they previously cherished. They will be called upon to sweep aside all their interior furniture; everything that once seemed important will be pushed to the edges of their consciousness.


Normally, we engage in hospitality within the context of two parties meeting on relatively equal footing. Often, there exists an unwritten social contract—an understanding that if one person provides food and drink, the other person will reciprocate with dessert, a bottle of wine, or sparkling conversation. Hospitality in the midst of a crisis is a different thing altogether. We must expand our definition.


Hospitality in crisis requires a willingness to walk into a place of someone else’s desperation, fear, anguish, and abject need. It is a context in which one party brings absolutely nothing to the exchange.


Offering hospitality in a crisis requires a certain athletic stance, an agility, on the part of the giver. There are a thousand barriers to action, hurdles that require an exertion of will and energy on the giver’s part to overcome. The first, and perhaps the highest, barrier you’ll need to leap is this: The responsibility for caring lies simultaneously with all of us and none of us.


It is easier to avoid responsibility than to accept it. Here are some of the different costumes we dress our avoidance in:


  1. It’s not my family, it’s not my job: Many of us are living lives without margin; our time and energy are already extended just short of the breaking point. For this reason, we often choose to draw stark boundaries around our generosity. But if a member of the body of Christ is in crisis, it is your family. And if they aren’t Christians, I’d argue your obligation to offer sacrificial love is actually increased. Consider rethinking your margins. Consider expanding your boundaries.


  2. Someone else will do it: No, they won’t. We’ve all been around humans long enough to know that, no, nobody else is going to do it. Everyone’s kids have soccer practice, rehearsals, play dates, and a cold. Everyone is working late this week. Everyone is tired. Everyone has plans. Crisis doesn’t wait around for a leisurely break in our schedules. Consider being the someone who does the thing.


  3. It feels awkward/I won’t know what to say: Many of us are burdened with the notion that in a moment of crisis, we must be ready to hit the perfect emotional pitch, dispense soothing words of comfort, or offer sage advice. The fear of not having the right words to say is often all it takes to sideline us, convincing us that if we can’t show up perfectly, we shouldn’t show up at all. Resist that fear. Trust the Holy Spirit to give you the words you need precisely when you need them. Consider, also, the power of silence. People in crisis often don’t need many words or solutions; they often just need someone to bear witness to their pain.


If these barriers of responsibility have prevented you from doing the hard thing when someone you know is in crisis, you’re not alone. I’m guilty of it. Most of us are. Instead of leaning in, we opt to send a text that reads: “I’m praying for you! Let me know if there’s anything I can do for you! Winky face emoji! Prayer hands!”


Let me make this abundantly clear. The person you’ve just emoji-bombed will have no idea what you can do for them. Their brain is in crisis, and the brain in crisis does not work rationally. It is capable of existing within this moment, and this singular moment only.


We send these hyper-spiritualized text messages because we are afraid of the unknown. We don’t know how our help will be received. We don’t know what we will say. We don’t know what is needed. The unknown is a big, scary place. I get it. But once we realize our sense of anxiety won’t actually kill us, we are enabled to take that next step. We must show up.


So go ahead. Show up in the waiting room. Show up for the tears. Show up when the marriage is fracturing. Show up when the job has been lost. Show up at the bedside. Show up in the heart of the crisis. Showing up is the single most powerful act of hospitality you can offer.


Unless you’re standing in front of that person in crisis—whose whole consciousness is hyper-focused on the moment they’re currently existing in—they will not be able to communicate what they need. Go stand in front of them.


Remember that the person in crisis is a human. The human body requires food, water, and sleep. Chances are good the person in crisis hasn’t thought about food in six hours. Don’t wait for them to ask. Bring them a bottle of water. A sandwich. A burger and fries. You don’t have to ask if they like white or wheat. It doesn’t have to be gourmet. Just bring food. When the person in crisis remembers they inhabit a body and that body needs energy, there will be food close at hand.


If immediate needs are covered, then what?


My advice? Get ridiculously specific.


Use your imagination. What comforts you when you’ve had a terrible day? Is it a jar of Nutella and a bag of pretzel sticks? A stack of magazines to flip through? Is it a vase of flowers? A satin sleep mask and high-quality pillow? Is it a gift card to a nearby coffee shop? Is it Sudoku and crossword puzzles and a box of perfectly sharpened Dixon Ticonderoga pencils? Is it a leatherbound journal and pen for recording prayers in the middle of the night?


Whatever the thing is, make it happen.


Maybe flowers aren’t allowed in the hospital room. Maybe the person can’t tolerate chocolate. Maybe they’ll judge you for your trashy magazine choices. Don’t take it personally if your gift doesn’t hit the bullseye. Eat the chocolate yourself. Give the magazines to the nursing staff. Hand the flowers to a stranger on the street. The gift isn’t the point. The point is that you showed up.


Here are some other tangible ways to offer hospitality in crisis:

  • Does the person in crisis have a safe place to sleep tonight? Can you offer a bed or a hotel room?

  • Do they need a change of clothes or toiletries?

  • Do they need a phone charger?

  • Do they need someone to feed their dog?

  • Do they need someone to whisk away their children somewhere fun for the day?

  • Do they need a cup of decent coffee?

  • What about a good book?

  • A Bible?

  • Do they need someone to sit quietly beside them?

  • Do they need someone to give them permission to sleep?

  • Do they need someone to be the point person for communicating with the rest of the community?


Understand that the person in crisis might have nothing to give conversationally or emotionally. They might not have any deep or significant words to say to you. They might have nothing but anger, sadness, or blank-eyed exhaustion. That’s okay. You might be longing to be that friend who gives a lingering hug. But they really might just need a phone charger. Meet the need of the moment. Solving for the day-to-day needs moves them from this moment to the next moment. This mundane problem-solving frees their minds, hearts, and bodies for the deep soul work they are called to undergo.


You have what it takes to make the worst moments of someone’s life less frightening, powerless, and lonely. Contribute your powers of intentionality and imagination to the mix. And maybe some muffins. Don’t be afraid. And if you are afraid, consider that—unlike the person in crisis—at the end of the day, you can go home, watch some Netflix, and sleep in the comfort of your own bed. You’ll be okay, I promise.


It’s uncomfortable to step into someone else’s pain. It is vulnerable to offer ourselves in this most sacrificial incarnation of hospitality. It requires gumption to show up and say, “Here I am.” But God himself is in the business of healing the brokenhearted and binding up wounds. So, go ahead. Show up. Join yourself to this holy work.


For your further reading and viewing pleasure:




An Alabama native, Kate Gaston was homeschooled before it was even remotely considered normal. She completed her undergraduate degree at Bryan College and went on to graduate school at the University of Alabama at Birmingham. For eight years, Kate worked as a PA in a trauma and burn ICU before ping-ponging across the nation for her husband’s medical training. She and her family are currently putting down roots in Nashville, Tennessee. Today, Kate enjoys homeschooling her daughter and tutoring in her local classical homeschool community. She also finds deep satisfaction in long, meandering conversations at coffee shops, oil painting, writing, and gazing pensively into the middle distance. You can read more of her work at her Substack: That Middle Distance.


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