Part of David Pascoe’s job as a palliative care chaplain is to stand by the bedsides of dying children, bearing and sharing the rage and despair of broken parents.

At Primary Children’s Hospital, it is a duty that drills down to the core of faith and the very essence of being human.

“There are about 160 to 200 deaths at Primary Children’s Hospital every year,” Pascoe explains. “Kids are flown in here from a five-state area. We take the worst of the worst cases, kids with the worst prognoses.”

While Pascoe emphasizes that for those youngsters who never leave the hospital alive, there are “many thousands more” who survive and thrive, the specter of death for the innocents weighs heavily on both medical and spiritual caregivers.

As a chaplain at the hospital in east Salt Lake City’s foothills, Pascoe has witnessed loss time and again. There is no comparison, he says, to “end of life” care for the elderly — which he did before joining Primary Children’s seven years ago.

“In hospice, I was dealing with people in their 70s, 80s or 90s, people who had usually lived full lives,” he says. “But to deal with children’s deaths? It’s absolutely inside out.”

Parents inevitably ask how a loving God could allow their child, any child, to die. Pascoe has no easy answers for them — or for himself.

“If this was a perfect world, children wouldn’t die. But in a world where children wouldn’t die, it wouldn’t be this world, and we wouldn’t be human beings,” he sighs. “What would it be? Heaven, paradise?”

Dying, his brain tells him, is part of the human condition. From the minute we are born, we begin to die.

“Whether we get to live 100 years, 100 days or 100 minutes … that is what being human is,” Pascoe says. “It’s not that God allows children to die; it’s that God allows everybody to die.”

But Pascoe and his chaplain colleagues know such intellectual gymnastics are cold comfort to grieving parents watching the light fade from their children’s eyes.

So, there’s the head — and then there’s the heart. Pascoe depends on the latter to guide him to comforting the hurting.

“My heart and my faith say to weep with those who weep,” Pascoe says. “It’s really all I can do, to witness with these parents the preciousness of their child’s life — the miracle their child is — and to mourn with them that their child’s life is ending so soon.”

In such cases, faith is two-edged. He remembers a grandmother learning that her grandson was brain dead; nothing more could be done.

“We should be celebrating our grandson’s first birthday,” she told Pascoe. “If there is a God, this must be a joke. I no longer believe in a God who could let this happen.”

Others find peace in their beliefs. “They say that it is only by the strength and grace of God that we can get through this,” Pascoe relates. “They move from praying their child will be cured … to praying that their child will be comfortable and pass peacefully from this life to the next.”

It is a sacred moment, no less than that of the biblical burning bush discovered by Moses. “The first thing God said to him,” Pascoe explains, “was, ‘Take your shoes off. You’re on holy ground.’”

Metaphorically, he says, that is what chaplains do when they approach the deathbed of a child.

“I don’t know if there is a greater honor that chaplains can be offered,” Pascoe says. “There is another presence in that room that you are there to bear witness to.”