Just recently, he was called to North Colorado Medical Center in Greeley on a code-blue in the middle of the night. An elderly woman's condition worsened dramatically after midnight, and Fowler found himself amidst her extended family who were wrestling with what to do.
The woman hadn't made her wishes formally known regarding automated resuscitation should her own system shut down, so the family had to decide whether to keep the machine running.
Fowler spent the wee hours talking with the traumatized family, offering emotional support and providing a link to hospital staff when medical questions arose.
"It was a difficult situation for the family because they had to make the decision for their loved one -- their daughter, their sister, their mother, their grandmother," Fowler said. "They had to all come together as a family and make that decision about what to do at that point."
The complexity of such situations is precisely why the Clinical Pastoral Education program at NCMC -- the only one of its kind in northern Colorado -- is an intensive, four-year training regimen that exposes students to the spectrum of circumstances, ethical questions and cultures they will face as chaplains at hospitals, hospices, prisons and churches.
"We provide holistic healing here at the hospital," said Mark Weiler, a board-certified chaplain and director of pastoral care at NCMC. "Doctors and nurses provide the physical care, but we provide the emotional, spiritual and psychological care."
Plus, as Fowler's late-night call illustrates, the program delivers much-needed emotional and spiritual support for families.
The Rev. Pamela Roberts is director of education for Centered Life ministry, which is the accrediting agency for the program at NCMC.
"The bottom line is spiritual care for the patients and support for the (hospital) staff," Roberts said. "Because folks go through intense spiritual crises when unexpected events happen or they face terminal diagnoses. They need support."
The process of training chaplains, Roberts said, is centered more on the nuances of relationships than specific academic content. The chaplain interns are trained to serve the spectrum of theological traditions and to be a spiritual ballast for people who are grasping for answers.
"When they walk into a room, they have to engage in a meaningful conversation with the person, which means they have to learn to use themselves. So, yes, their guts get turned inside out when they do this," Roberts said. "It's not just a cognitive experience."
The students learn not only to serve God, but also to deeply listen to people, Roberts said. She said the students can't help but deepen their own faith as they work to help others spiritually heal.
"You can't not be profoundly touched when you see someone ... who comes in from a car accident, where they were on their way to the store and suddenly their whole life is changed," Roberts said. "It raises deep questions."
For Fowler, 55, becoming a chaplain was a calling. He had been a program director for United Way of Weld County when he felt a tug to go in a new direction.
He is working a couple part-time grant-writing jobs while performing his visitation and classroom hours with the pastoral education program.
If Fowler wants to become a board-certified chaplain, the road is long. He needs to finish this program, then complete three years of study for a Master's of Divinity degree. Then he would appear before a board of chaplains for a review. If the board is satisfied with his answers, Fowler would become board certified.
The NCMC chaplain program began in 1995 with Rolf Brende as the spearhead. Brende started the pastoral education training program two years later as a way to help handle the workload of the growing hospital.
Weiler joined the hospital as its second board-certified chaplain four-and-a-half years ago. Brende, who is nearing retirement, is now a part-time chaplain, essentially giving the hospital 1 1/2 staff chaplains.
This year, there are eight students in the pastoral education program, each contributing 300 hours of visitation service, for 2,400 hours total, in the hospital. The students are an even mix of men and women.
"By having this program we can serve a greater amount of patients and families," Weiler said. "And the cost of the program is less than it costs to hire one full-time chaplain."
And because physicians and nurses are often busy with their work, they don't necessarily have the time to spend with families, Weiler said. That's where chaplains and the interns step in as valuable contributors to the team effort of support and caregiving.
When a family comes into the hospital, sometimes in a state of shock, Roberts said, the chaplain's role becomes paramount.
"When you're making ethical decisions that are life and death, it's important to take the person's values into consideration," she said.
In Fowler's recent early morning code-blue call, he waded directly into such a difficult decision-making process. The key, he said, is not to impose any values, but rather help the family articulate their own.
"We're trying to help draw that out of them to help them make a decision that's best for them," he said.
And with the numbers of cultures expanding in Greeley -- such as about 1,000 East African refugees and asylees arriving in recent years -- the challenges for chaplains keep growing.
Cultures have different beliefs about blood transfusions, for instance. For Muslims, it's not generally appropriate for a male chaplain to visit a female patient.
"There are challenges we learn and face as our community changes and grows," Weiler said.
The program includes presentations where students learn about gangs, the hospital's burn unit and the dynamics involved in substance addiction, emotional and physical abuse and suicide.
Fowler is getting a real-life immersion in the complexities of his chosen field. Even as an intern, the ethical questions are profound, the demands to listen and support are deep -- and there are days when his guts get turned inside out. Still, he can think of nothing more rewarding to do.
"I love the chaplaincy, so I'm going to do it for as long as I'm able," he said.
(Copyright 2010 by the Associated Press, All Rights Reserved)