by Gordon Nary
Gordon: When did you first receive your calling, with whom did you first discuss it, and what advice did they offer?
Frederico: I felt called to be a priest for the first time as a teenager, and later, in my late thirties, I felt called to be a Jesuit Priest. However, the specific calling to work with the sick, what some might call the "call within the Call," came to me during my later teenage years, around the age of nineteen.
Throughout my vocational discernment process, I had various spiritual directors. During my initial training as a diocesan seminarian in Uruguay, Father Daniel Martinez guided me with his approach to "finding God's will for me." Later, as a Jesuit, Sister Jane Ferdon, O.P., facilitated conversations where we sought to understand what Jesus was saying or not saying regarding the matters we discussed.
The advice that has resonated with me the most over the years is to "make time to pray and find a quiet place for a conversation with God, listening to His guidance," and "avoid making major decisions during difficult times." Additionally, as I reflect on the good things in life, I've learned to pay attention to my inner world, particularly identifying what brings me consolation and desolation.
Gordon: Tell our readers about your priestly formation
Frederico: My priestly formation has taken place over the last thirty years.
The first stage was in Uruguay, South America, at the "Inter-diocesan Seminary Cristo Rey" from 1997 to 2004. During this time, I was immersed in the world of suffering in the medical field, learning about the plight of those who not only suffered from severe illness but also lacked various types of support, particularly the poorest among the poor.
The second stage was with the Society of Jesus in the West Province (California) from 2017 to the present. The Jesuits have an extensive and enriching formation process that spans several years and exposes us to various pastoral realities of God's people. My favorite courses were liturgy and canon law during my first formation stage. In this second stage, at the Jesuit School of Theology in Berkeley, I particularly enjoyed courses on Sacred Scripture, Creating Sacred Spaces, and Spiritual Direction. I found courses with practical applications, such as Spiritual Direction, Pastoral Counseling, and Creating Sacred Spaces, to be the most fulfilling, as they allowed me to engage with the people of God in pastoral care directly.
Between my first and second stages of formation, I underwent Clinical Pastoral Education training at St. Camillus Interfaith Catholic Center for Urban Pastoral Care, and across the street at LAC USC Medical Center, I received training in Palliative Care and Hospice care.
Gordon: Why did you decide to become a Jesuit?
Frederico: I'm not sure it was entirely my decision; I believe God called me to join the Jesuits in 2015. This was surprising because my previous formation was as to be a diocesan priest. Joining the Jesuits in my late thirties, at an age considered older for Jesuit formation, and having been engaged in various pastoral ministries unrelated to education, was unexpected. I am someone who seeks community, in a unity of spirit and heart, in serving the people of God within the brotherhood of the Society of Jesus.
The Jesuit mission, which extends beyond geographic boundaries, encourages us to step out of our comfort zones and embrace ministries that may be unfamiliar but are necessary in the world. Jesuits are involved in diverse fields, and the pursuit of salvation takes on various shapes and forms. The ministries on the frontiers, working with marginalized communities in both civil and ecclesiastical contexts, draw me to dedicate my life as a Jesuit.
The Jesuit spirituality, centered on finding God in all things, coupled with the practice of the examen of conscience, helps me become aware of God's presence not only in my life but also in the lives of my fellow sisters and brothers.
An aspect that resonates deeply with me is the connection between palliative care – and hospice in St. Ignatius's hospital experience. Before joining the Society of Jesus, I was already a board-certified professional chaplain specializing in Palliative Care and Hospice. St. Ignatius of Loyola's experience serving the sick and dying during his pilgrimage at Manresa profoundly influenced his vocational life. He shaped how a Jesuit should be formed. This experience, known as the "hospital experiment," is a mandatory part of Jesuit formation, where each Jesuit provided holistic care of the sick. Today, this holistic approach is known as palliative care and hospice care. The first Jesuits assigned to help in hospitals or the battle of epidemic outbreaks were charged with all kinds of work in providing for the very sick and dying, including their spiritual and religious needs.
As a Jesuit missioned to Belize to establish the first hospice facility, providing care for the terminally ill and advancing palliative care in the country, I feel blessed by God and affirmed in His call to me.
Gordon: I understand you are a Jesuit Scholastic awaiting ordination as a priest. Do you have an approximate timeline for when you will be ordained?
Frederico: No, I don’t. The Jesuit formation for the sacred orders of diaconate and priesthood typically takes about ten to twelve years, sometimes even longer. Although I may have completed all the academic and ecclesiastical requirements for ordination, I have only been in the Society of Jesus for about seven years. My Jesuit identity is still evolving, and it seems that with more years of experience in Ignatian spirituality, certain aspects will become more integrated. While it is a personal discernment to some extent, it is also a communal discernment involving the West Jesuits Provincial, Father Sean Carrol, S.J., the provincial delegate for formation, and the province consulters.
In the meantime, I am fully engaged in my Jesuit mission in Belize. As the Jesuit Community Minister (house manager), I ensure that my Jesuit brothers have everything they need to fulfill their mission in daily life. Additionally, as the Executive Director of the Belize Hospice and Palliative Care Foundation, I provide home-based care for those who lack the financial resources to access this type of care. It is a process in which the Holy Spirit is guiding, and I trust that I will be ordained as a deacon and priest by the mission entrusted to me in due time. My heart, mind, and feet are firmly planted in Belize.
Gordon: Tell us about your work as a Cancer Care Chaplain in the Bone Marrow Transplant Program and Cancer Care Center at Stanford Health Care in Palo Alto, California.
Frederico: It was an incredible professional opportunity; I consider myself fortunate because work never felt like work to me. Becoming a chaplain was a calling within the larger calling, and palliative care became a passion that brought out my best learning and teaching capacities. As a Latino who struggled with English, being hired by a prestigious medical teaching institution like Stanford Health Care was an honor that boosted my confidence in the skills I had developed and the wisdom I had accumulated from my previous years at the Los Angeles County and University of Southern California Medical Center (LA General Hospital).
My work primarily focused on the bone marrow transplant unit, where patients, their loved ones, and healthcare providers experienced a high level of suffering. I provided support to the professional staff every week to help alleviate and prevent burnout and compassion fatigue. This created an environment of teamwork where various teaching and learning opportunities emerged.
Professional chaplaincy became a weekly teaching opportunity to learn about the spiritual dimension, spiritual pain, and its manifestations in patients with advanced serious illnesses and those nearing the end of their lives. It became imperative to address the person's "Total Pain" to improve their quality of life. The transdisciplinary approach highlighted the need for healthcare professionals to recognize their expertise in their fields and to utilize generalists to address the person's holistic needs, including their spiritual and religious concerns. It was fascinating to see physicians, nurses, social workers, and chaplains step out of their comfort zones to discuss aspects of fields outside their own expertise, such as chaplains discussing illness progressions, symptom management, and opioid use.
I had the opportunity to collaborate on several projects, including translating and presenting the documentary "Being Mortal" to initiate conversations about goals of care and facilitate the completion of Advance Directives using tools like the "Stanford Letter." Another project involved participating in a discussion panel with a physician whose wife, also a physician at Stanford, wrote a book titled "When Breath Becomes Air," sharing their experience with her husband's end-of-life journey.
One project that was particularly close to my heart, although it was a collaborative effort with the Stanford Clinical Pastoral Education Program, was the development of a curriculum for chaplain training based on my experience at USC Medical Center. We created a one-year fellowship training program for chaplains pursuing professional advanced certification in the palliative care field, consisting of four units of Clinical Pastoral Education. It was a rewarding experience to collaborate in mentoring, supervising, and refining the training program.
Gordon: You currently serve as a Palliative Care Hospice Chaplain. What are your primary responsibilities?
Frederico: Currently, I am the Executive Director of the Belize Hospice and Palliative Care Foundation, a nonprofit organization transitioning to become the Belize Palliative Care Hospice Association. Our organization provides home-based care for individuals lacking the financial means to access this type of care as they navigate the progression of serious, terminal illnesses. While we serve all demographics, our primary focus is on those without access to such services in Belize. In my role, I oversee the daily operations of our team and office, managing administrative procedures, fundraising efforts, and patient care initiatives. With a firm commitment to compassionate care, I work closely with Dr. Martha Habet, President, and Dr. Ramoncito Yacab, Vice President, to ensure the seamless coordination and execution of our mission.
Regarding fundraising, I actively seek international resources since philanthropy is not as deeply ingrained in Belizean culture as it is in the US. My primary objective is to establish a facility that can provide care for terminally ill patients who would otherwise face their final days alone while also serving as a program for those interested in learning about palliative and hospice care in a hands-on setting.
The Central Southern Jesuit Province Mission Advancement has been a valuable collaborator, facilitating tax-deductible donations for our cause. Every donation was transferred to the local Jesuit community in Belize and then to the Belize Hospice and Palliative Care Foundation. For those interested in supporting this initiative, donations can be made through this direct link: [Link provided]. After selecting the amount, donors can designate their contribution to ministries in Belize, with "Frederico Gianelli, SJ – Belize Hospice" noted in the comment box.
Since my arrival in August 2023, with the generous support of donors, we have provided palliative care and hospice training to almost 200 individuals from both medical and non-medical backgrounds. We have partnered with various organizations, including the Society of Jesus in Belize, the Belize Ministry of Health, the Belize Social Security Board, Food for the Poor, the University of Belize, the Pallottines Sisters, the Belize Roman Catholic Diocese, and the local Rotary Club.
Additionally, we have hosted volunteer immersion trips from Jesuit and non-Jesuit universities in the US. The local Jesuit community where I reside can host up to 20 people, providing accommodation with air conditioning, a kitchen, dining room, chapel, recreation room, and laundry facilities within the secure St. John’s College Campus on a 24/7 basis.
Gordon: What impact does spiritual care have on the dying process?
Frederico: Research in palliative care, particularly with advanced cancer patients, has demonstrated the importance of addressing the spiritual dimension and spiritual pain to achieve a good quality of life.
Since Dame Cecily Saunders (1967), the pioneer of the modern hospice movement, it has been recognized that palliative care must address the spiritual dimension. Failure to do so renders it akin to any other medical practice devoid of holistic care. To comprehensively address "total pain," we must imperatively attend to the spiritual dimension alongside the physical, psychological, and social dimensions.
As the body deteriorates, the physical dimension diminishes while research on advanced cancer patients indicates that the spiritual dimension gradually emerges as the primary source of distress, manifesting as physical, psychological, and social pain. Physical pain, often managed medically without success, can sometimes be a manifestation of spiritual pain. Similarly, symptoms like insomnia, shortness of breath, agitation, depression, and a desire for prolonged hospitalizations or increased opioid use can be linked to spiritual anguish, stemming from past experiences, present circumstances, or uncertainties about the future. This pain is unique to each individual, and the role of a professional chaplain is to facilitate its identification, address it, and enhance the person's quality of life.
The spiritual dimension extends beyond religion, encompassing the search for meaning, hope, a sense of belonging through significant relationships, and reconciliation with oneself, others, and the divine. It includes the deep personal connection with what the individual identifies as Sacred, which may encompass religious faith traditions significant to their life and worldview. For some patients, spiritual pain may arise from a perception of illness as divine punishment, rooted in feelings of guilt, regret, or fear stemming from past experiences. Unresolved issues with loved ones, the acceptance of approaching death, and uncertainties about the afterlife can also contribute to spiritual distress.
In summary, spiritual care at the end of life has enhanced the quality of life for those facing mortality. By embracing the end-of-life process and organizing their affairs across all domains, individuals can experience life to the fullest extent possible, with a peaceful and natural passage towards death.
Gordon: What plans do you have after ordination?
Frederico: I plan to focus on my mission here in Belize. When the time for ordination arrives, I will discern with my superiors how the future will unfold. First, I will be ordained, and then we will listen to the guidance of the Holy Spirit through my provincial and discern the needs to which I am called for mission.
Gordon: Thank you for an exceptional and inspirational interview.