In 2015 McCall Alexander Carmichael (MAC for short) was a beautiful, happy, sweet 17-month-old who was “wise beyond his years,” said his mother, Brandi. Born with large dimples and chubby cheeks, he earned the nickname “Cheeks McGee.”
“One day he was in a cart at the grocery, and an older lady walked by and said, ‘Oh my goodness! You could plant flowers in those dimples they’re so deep,’” Brandi recalls.
On Dec. 18, 2015, Brandi and her husband, Hunter, planned to meet in the food court at Cool Springs Galleria to have a quick dinner with Brandi’s sister and daughter before taking the children to see Santa. The mall and food court were bustling with people doing their last-minute shopping.
Brandi, coming from work on West End Avenue, encountered surprisingly little traffic, snagged a rare parking spot near the mall’s food court, and got to the table just as Hunter was breaking up MAC’s chicken nuggets and fries into tiny pieces.
As Brandi got to the table, MAC coughed with food in his mouth. Then he choked. As his family tried in vain to do all the things they were taught to do when a child is choking, a cardiothoracic surgeon and a pediatric nurse eating at nearby tables ran to help. Nobody could dislodge the food. Someone called 911 and despite the heavy traffic around the mall, the fire department and an ambulance got there quickly. But MAC’s heart had stopped.
He was taken to Williamson Medical Center, where his heartbeat was briefly revived, then to Monroe Carell Jr. Children’s Hospital at Vanderbilt, but there was nothing that could be done. He had suffered irreversible brain death.
“The doctors and nurses at Monroe Carell did everything they could possibly do to help our child. They took excellent care of us and our family, and we couldn’t be more thankful,” Hunter said. “But eventually there came a point where the doctors couldn’t do anything, and things weren’t going to go in MAC’s favor.”
The grieving family had one need that was unmet at Monroe Carell — at least temporarily — spiritual care.
“There was a moment late that night when we asked to see a chaplain, and there wasn’t one on duty, and I was shocked,” Hunter said. “They told us there was one chaplain who was there during the day, but any other time they had to bring in volunteers. Fortunately, they found someone for us, and they came in.”
The Carmichaels remained at Monroe Carell for three days while two separate cognitive tests were performed on MAC, who remained on life support. During that time, the spiritual care team did everything they could to help the family.
“We are of Christian faith, and Mac had not been baptized. They did that for us. They helped us through,” Hunter said.
The Department of Spiritual Care at Monroe Carell is instrumental in providing compassionate, patient- and family-centered care at various stages of a child’s medical journey. Chaplains create a safe space for spiritual expression during what is often a challenging time in a family’s life. Additionally, chaplains play an invaluable role in supporting staff by decreasing caregiver burden and lessening compassion fatigue.
Several months after MAC died, thinking back on the lack of availability of the spiritual care team that night, the Carmichaels established the MAC Carmichael Fund to raise support and awareness in the community for spiritual care resources. They started the annual MAC Sized Bass Tournament to raise donations to help ensure that spiritual care is staffed and can provide invaluable support for patients and families in the hospital. This year, the ninth annual tournament will be held on April 28.
The MAC Carmichael Fund, along with the generosity of Tri Star Energy and Fran Hardcastle, both longtime supporters of Monroe Carell who have supported various initiatives and programs throughout the hospital, have allowed Monroe Carell’s Department of Spiritual Care to grow.
In 2010 the department consisted of one full-time chaplain who was at the hospital mostly during the daytime hours. Today there are three full-time and one PRN chaplain, along with a pool of contract chaplains who provide overnight and weekend coverage.
“Certainly, those gifts have helped us grow,” said Janet Cross, MEd, CCLS, CPXP, senior director, Patient and Family-Centered Care, adding that the Carmichael fund has exclusively allowed the hospital to employ overnight chaplains. “When they lost MAC it was at night, and no chaplain was available. They’ve been focused on making sure no other family had that experience, and their gift has made the overnight chaplain coverage come true.”
The support from Tri Star and Fran Hardcastle will allow the continued growth of the spiritual care team.
In 2020, Tri Star Energy established the Tri Star Energy Chaplain Fund to enhance spiritual care at Monroe Carell through funds raised from the Twice Daily Cup, a local charity golf tournament, and point-of-sale campaigns in Twice Daily stores.
“Partnering with Monroe Carell Jr. Children’s Hospital at Vanderbilt has been a crucial part of our commitment to giving back to the community for nearly the past 25 years,” said Steve Hostetter, CEO of Tri Star Energy and former Monroe Carell Advisory Board chair. “It is so meaningful for us to be able to support the incredible work of the Spiritual Care Program and the hospital chaplains who help patients and families when they need it most.”
Cross said that spiritual care is important to the overall mission of Monroe Carell. “We are beginning to see evidence that attending to spiritual care, just like our child life specialists attend to a child’s emotional care, is going to make for better outcomes when you’re treating the whole child and family,” she said.
The spiritual care team is available to meet patients, families and staff “where they are,” said the Rev. Lisa Hermann, MDiv, BCC, a staff chaplain.
“We’re not there to push one path or one way of thinking. It may be somebody who is religious or someone who is spiritual or someone for whom faith, spirituality and religion is not a resource for them. But we’re still there if they’ll have us, reminding them they are not alone,” she said.
“I often describe it as a triangle or a mountaintop. We are there for the deep dark valleys and difficult times ― the hard news and the new diagnoses ― but also there for the middle-of-the road days when things are just kind of meh, and also for the peaks and highest points ― the celebrations, the good news, the first breaths when we extubate someone, the first slice of pizza people get to consume,” Hermann said.
The Monroe Carell chaplains are theologically and psychologically trained and also have training in normal childhood development.
The growth of the program has not only allowed the chaplains to reach more people in need, but to also be more expansive in their services.
“When we only had one chaplain here, there were limits as to what we could do for our patients, families and staff,” Hermann said, adding that she is grateful to the Carmichael family, Tri Star, and Fran Hardcastle, all who have allowed the program to grow.
“I’m grateful the Carmichael family saw the need and the value for quality spiritual and emotional care at all hours. That’s what we aim to provide,” she said.
Hermann said the chaplains are not just “pastors at the hospital. We are trained clinicians who provide spiritual and emotional care in the clinical environment and who are trauma informed. That’s what’s recognized by these gifts. Monroe Carell is putting well-trained chaplains side by side with the doctors, nurses, environmental services, food service, care partners, child life, social work and all things in between to help care for our patients, families and staff. It’s an honor to do that in MAC’s memory and to have the community and corporate world support what we’re doing.”
The Rev. C. Fred Brown, MDiv, BCC, a staff chaplain who was originally an overnight chaplain covering Monday nights, said, “Without the donors’ generosity, I wouldn’t be working here full time. Their gift allowed me to gain invaluable experience in pediatrics, which helped make me a good candidate for this position when it became available.
“The hospital is an incredibly vulnerable place. I know for a fact that it matters to have this coverage,” he said. “Many times, over the past three years that I have been here, I have been at the end of my shift with multiple patients arriving in the emergency department needing support. On these occasions we’ve been able to call in back up to assist.”
Brown said that a buzzword in spiritual care is “inclusive,” but Monroe Carell wants to be “expansive.”
“Inclusion says you can come sit in our space. Expansion says we have enough room for everyone’s particularity and way of being — it’s all of our space.”
Brandi Carmichael said helping support the spiritual care program at Monroe Carell has been therapeutic for her family and ensures that MAC won’t be forgotten.
“I don’t want people to ever forget him. I don’t want people to ever not know he was here,” she said. “It was such a magical 17 ½ months. From the moment we knew he was coming … I didn’t know my heart could be so big. I don’t want to ever forget the magic of being MAC’s parent, and I don’t want people to forget that he was here and how important his life still is.”
The ninth annual MAC Carmichael Fund “MAC Sized” Bass Tournament will take place on Sunday, April 28, at Fate Sanders Marina in Mt. Juliet, Tennessee, to raise additional resources for the spiritual care program. Learn more and register here.
