What is your gut reaction when you hear the words “hospital chaplain?” Maybe it’s an eye roll or confused stare about what you believe to be an incoming attempt at religious conversion. As a family member anxious about a loved one in the hospital, maybe it’s a sigh of relief. As a patient, maybe it’s an overwhelming fear of incoming bad news. Health care chaplaincy is chronically misunderstood, beginning with the Christian connotation of the term “chaplain” which looms over perceptions of the field.

Hospital chaplains deliver spiritual care to patients and families. This can range from leading prayers and offering religious services to working through the distressing spiritual and religious crises that often emerge in the ambit of the hospital. However, chaplains exist in a sort of limbo, caught between two formidable worlds: the world of medicine, in which health problems are actively “fixed,” and the world of spirituality. Pulled in both directions, chaplains function on the margins of medicine.

This summer, as a pre-med undergraduate student majoring in Medicine, Literature and Society at Columbia University, I spent time shadowing several staff chaplains “on-call” across New York-Presbyterian Hospital’s busy Columbia campus, visiting individuals in all seasons of life: expectant and newly minted mothers with very sick babies, children and young adults facing serious illness, and older patients at life’s end in the intensive care unit.

Many of our visits started off with a hurried disclaimer: “Hi. I’m a chaplain. Sometimes that scares people, but I’m not here to push anything religious or to deliver any bad news.” Some were quick to refuse politely, but many proceeded to take a journey within and share, with the utmost transparency, narratives of all sorts. From stories of spiritual reawakening to devastating tragedy to cathartic emotional release, we crafted a safe and welcoming environment for patients and family to be able, even for a brief moment, to ignore the strict confines of the hospital walls and enter a nurturing space of reflection allowing for deep vulnerability and a reclaiming of strength.

What followed was an unraveling of a vast emotional spectrum. An expectant mother, scared and questioning her faith, nevertheless hopeful after a devastating prenatal diagnosis. A loving daughter proclaiming to her teary-eyed, hospitalized father that he was the best father she could ask for. A committed family in the intensive care unit, linking hands with their loved one in those last fleeting moments of life. The pure joy of a dementia patient as we uncovered his great passion for gospel music and played his favorite hymns, seeing the twinkle return to his sad eyes. Coming together, upon many patient and family requests, to hold hands and close our eyes in prayer, meditation, and blessings — the raw emotion and fervent grasp of hope were often palpable.

Chaplains affect tangible change upon interacting with patients and families in the hospital. The simple act of sharing a personal narrative holds immense powers of healing. As our visits came to an end, we would ask: “Is there anything else we can do to help?” The resounding response was “No. Just talking was incredibly helpful.” In the midst of an inevitable host of negative emotions generated by the hospital, there exists great power in the simple act of human connection with a chaplain. Such connection and overt acknowledgment of a patient’s humanity rather than a medical condition can be far too easily trivialized or dismissed by medical staff who are exhaustively confronting problems of a deeply corporeal nature.

Particularly in hospitalized patients who face significant illness, life reduces down to a skeletal structure of the utmost existential importance. Patients find themselves questioning the very foundations of life: What gives hope and meaning to my life? Who makes up my support network? What makes my life worth living? As the art of health care chaplaincy is deeply rooted in communication, chaplains are professionally trained to engage in conversations that allow patients to grapple with these sorts of questions.

Despite the prominent role of spirituality and religion in making health care decisions and the often strong need for psycho-emotional support during hospitalization, there exist many barriers to involving chaplains in patient care. Compounding preconceptions concerning the religious aspects of chaplaincy, a lack of awareness of the chaplain’s role, and the typical association of a chaplain’s arrival with impending bad news or a death, what results is a chronic underutilization of chaplains.

In the intensive care unit, chaplains are particularly underutilized as it is “traditional” only to call the chaplain when a patient is dying. In addition, chaplain interaction with critically ill patients is often limited because many are intubated and physically unable to speak. At Columbia, we have pioneered the use of a novel spiritual-care communication board, which allows chaplains to deliver spiritual care even to patients who cannot speak but are awake. Clearly, chaplains can do so much more than provide comfort during and after a death; they serve as guides through life’s most trying moments, providing crucial support not only in times of grief but to those patients who survive and must then readjust to life after the hospital.

Instead of shying away from hospital chaplains based on inaccurate preconceived notions, it is time to think of chaplains as our friendly and indispensable allies in the hospital. Chaplains are dynamic individuals who are able to morph into the support figure most needed in any given moment: whether it be an advocate or attentive listener, chaplains are spiritual care specialists trained to help patients and loved ones navigate a hospital stay, which can be a quite isolating and difficult experience.

In the hospital, just as the medical staff takes care of patients in the physical respect, chaplains take care of the mind and soul. A healthful life is not limited to good physical health but encompasses strong mental, emotional, and spiritual health as well. Let us, therefore, embrace chaplains as members of the health care team who play an integral role in the healing journey to comprehensive well-being.

Ilaria Simeone is an undergraduate student.

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