Barfield has spent a great deal of time considering what it means to work with dying children. Before coming to Duke Divinity School, he spent eight years working in oncology and bone marrow transplantation at St. Jude Children’s Research Hospital in Memphis, Tenn.
One patient in particular left a deep impression on Barfield.
Ali Mills was a 12-year-old girl with a big smile and a deep faith in God when Barfield met her at the hospital in 2004. She had survived neuroblastoma as a 5-year-old, and her family thought she had beaten the disease.
When the cancer returned, Ali underwent a bone-marrow transplant at St. Jude, and she eventually became Barfield’s patient.
Ali’s treatment went on for months, and Barfield found he was spending more and more time with her and her mother, Nancy.
Sometimes he would just come by to chat. Sometimes he would sing to Ali, who got a kick out of hearing Barfield sing the theme song to the SpongeBob SquarePants cartoon. Other times the conversation was more serious, focusing on the spiritual. Ali’s church eventually arranged for her to be baptized in her hospital room.
“Typically, doctors don’t serve as deep witnesses for their patients,” Barfield says. “They write orders, put out fires, and get ready for the next day. In 15 years as a physician I had never really witnessed suffering. For the first time I got a direct experience of what it’s like to suffer — not for the week that I’m on service, but week after week after week.”
Ali died shortly after her 13th birthday, her body damaged beyond repair first by the cancer itself and then by chemotherapy and other harsh treatments. Barfield spoke at her funeral in Memphis. Her photo, perpetually grinning and youthful, sits on his office bookshelf, a reminder of what she taught him.
Through this and other experiences at St. Jude, Barfield refined his thinking about how medical practitioners can work with families, clergy, and others to best support their patients. There he began to formulate the questions and ideas that he’s now exploring at Duke.
Barfield sees involvement of the church as natural.
“For centuries this was the church’s domain: frailty, illness, fear, and grief,” Barfield says. “In recent years the church has relinquished much of that to the hospitals.”
That conviction comes from his own faith life as well as his experience in the medical world. The son of a Presbyterian minister, Barfield has great respect for theological inquiry. His wife, Karen, is an Episcopal priest.
The opportunity to work with the Institute on Care at the End of Life, whose work crosses disciplinary boundaries and focuses on the intersection of spirituality and medicine, especially attracted him to Duke.
“The institute is working on tools to help clergy in training and in the field to take a greater role in helping people — even those with terminal illness — live well in hopeful communities,” Barfield says. “We can’t just rely on the hospital at the end of life. It’s about a continuum, with the hospital, hospice, home health care, and congregations. That’s how you ensure a good end to life.”