What a Chaplain Actually Is, and Why You Might Want One
by Robert Drake
If you grew up watching MAS*H, you have a chaplain in your head already. Father Mulcahy — gentle, earnest, slightly out of place among the surgeons and the chaos, offering prayer and last rites and a kind word in the dark. He is a good man. He is also not what most chaplains are, and perhaps not what you need when the world falls apart — unless, perhaps, you are Catholic.
Let me tell you what a chaplain more often is. I’ll start with two of my chaplaincy failures.
Some years ago my younger sister was diagnosed with stage four throat cancer. Two weeks after her diagnosis, at the beginning of chemo and radiation treatments, she told me — through our youngest sister — that she would rather I not call her anymore. It was, she said, hard enough for her without “Bobby putting me in my grave, already.”
I was stunned, remorseful, and humbled.
I had shown up as a seasoned hospice and palliative care professional. An expert. Her big brother who knew about these things. I had not shown up as someone present to what she actually needed.
It took me two weeks to assure her there would be nothing from me but support — that I would serve her as she needed, not as I thought prudent. She said: “Great. We understand each other.” She was treated, went into remission and for a few years more she survived.
Not long after, I had a palliative care patient with colorectal cancer who had survived two years beyond his prognosis. He and his wife had no doubts about how: “…the power of positive thought and love.” When I visited again and it was clear he had only days left, I asked him in my compassionate but “look death in the face” no-nonsense chaplain fashion: “Are you afraid?”
His face changed to a scowl. With his limited air and energy he said: “What is wrong with you people? I have nothing to be afraid of. This is just my body purging toxins.”
In thirty years together this couple had never raised their voices to each other in anger. They needed to deny death. That denial had kept him alive and them unified in love for two extra precious years. He died peacefully two days later.
I was wrong. They knew what they needed. I had forgotten, in my expertise, to be present to them.
The painful truth is that in spite of my experience with so many deaths and thousands of patient visits, I sometimes forget what I am actually there for. I am not there to tell the truth as I see it. I am there to be present to the truth as they are living it.
I have been either training for or doing this work for nearly two decades. I have sat with the dying in hospice, skilled nursing, and assisted living, in ICUs and emergency rooms, in pediatric oncology wards where the patients are children and the grief and courage are both unspeakable. I have accompanied people choosing medical aid in dying — not escaping life, but refusing to endure intolerable terminal suffering at its end. I have worked in psychiatric forensic units with residents found not guilty by reason of insanity. I have sat in restorative justice circles at San Quentin prison with men serving life sentences where showing weakness is dangerous and hugging is punishable, accompanying them in their own long reckoning with the harm done and the humanity somehow retained.
I am also not very religious.
I am an interfaith chaplain, which means I am trained in the beliefs, practices, and sacred texts of many traditions — Christian, Jewish, Muslim, Buddhist, Hindu, and beyond. I can pray with you if you want prayer. I can sit shiva, honor Ramadan, or simply hold silence with you in whatever way your tradition, your condition, or your grief requires.
But what drives me is not religion. It is philosophy. I bought my first book in fourth grade — the Dialogues of Plato. I have carried it, in one form or another, ever since — Socrates and his unwavering dedication to truth and virtue, unafraid of death. Socrates said, “the trick, my friends, is not avoiding death but avoiding unrighteousness — for that runs faster than death.” I have the Delphic dictum know thyself tattooed in Greek on my arm, not as decoration but as guiding methodology. My early graduate work was in philosophy and conflict resolution, grounded in Kantian respect for persons — the radical, unconditional idea that every human being possesses inherent dignity, regardless of their beliefs, their diagnosis, their history, their position in life, or their condition.
That is what I bring into every room. Not a denomination. A commitment to your worth as a human being.
So what does a chaplain actually do?
The honest answer is: it depends on what you need.
A chaplain is trained to enter any situation — any prognosis, any diagnosis, any social or economic circumstance, any faith tradition or philosophical framework or absence of either — and be present for what that person and their family actually needs. Not what we think they need. Not what would make us comfortable. What they need.
That requires something more demanding than good intentions. It requires knowing yourself — your own beliefs, your own losses, your own background, your gender and race and history and the assumptions you carry because of all of it — well enough to serve rather than impose. A tall white man from a middle class background walks into a room carrying all of that whether he acknowledges it or not, and who he is generates a response from those he meets. I carry the fraught relationships with my dead parents, the experience of growing up in the Midwest. The training is in the acknowledgment. In knowing what you bring so it doesn’t arrive uninvited. This is why we usually do a supervised internship in a clinical setting for at least a year, being forced to do verbatim recreations of patient and family encounters — questioning everything we said and did.
This is why chaplaincy is not interchangeable with good nursing, or skilled therapy or social work, or a caring friend — though all of those matter enormously. A chaplain is specifically trained in the territory where medicine reaches its limits. Where the diagnosis is clear and the prognosis is terminal and the question is no longer what do we do but how do we be. Where the family is shattered and there is nothing to fix and someone needs to stay in the room anyway — vulnerable, feeling, present to the pain without running from it.
We are trained to stay. Without an agenda. Without needing it to resolve. What we strive for is reconciliation of suffering, of a life lived, of loss and of need, of broken dreams and relationships.
Manuel was an ex-con out of San Quentin and Pelican Bay prisons. He had tattoos everywhere. He also had rheumatoid arthritis so severely he was twisted in spine and every limb. He couldn’t bear to be touched. Even sound hurt. He had sepsis. He had liver disease. He was obnoxious to the staff because he was “difficult.”
Manuel was asleep when I arrived. I pulled up my chair quietly and I waited.
For a long time, I waited. I watched him and channeled love to his twisted body and psyche. He awoke and, opening his eyes, said — after a long silent assessment of me — “Who the fuck are you?”
“Who the fuck do you think I am? I’m your hospice chaplain, Bob.”
We hit it off. I served him until he died.
Ministry of caring presence for Manuel? Spiritual leveling, respect, silence, candor.
Near the end of his life, one of my patients confided in me his treason and war crimes. He had carried this burden alone for over half a century. He wasn’t asking for forgiveness. He knew that was between himself and eternity. He needed only the presence of an unjudging human witness.
What he needed was simple caring, compassionate presence.
That is the work. Not preaching. Not saving souls. Not offering answers to questions that have no answers. Just — remaining. Present. Unjudging. Fully human alongside another human at the hardest moment of their life.
Chaplains are more diverse than most people know.
We serve in hospitals, hospices, prisons, military units, disaster response teams, university campuses, and corporate settings. We come from every faith tradition and some from none. There are Buddhist chaplains and humanist chaplains and chaplains who, like me, are better described as philosophers than believers — grounded not in doctrine but in the dignity and worth of every person who sits across from them.
What unites us is not theology. It is a commitment to compassionate presence. To accompaniment. To the belief — or the practice, which is sometimes more honest than belief — that no one should face the hardest moments of their life or their death alone, without someone trained to be there fully, without flinching, without an agenda, without needing them to be other than they are.
If you are facing a serious illness, or accompanying someone who is — call a chaplain. You do not need to be religious. You do not need to be spiritual. You do not need to believe anything in particular. You need what every human being needs at the edge of their life: someone genuinely present. Someone who will not look away. Neither trying to change you nor explain away what you are going through.
If you work in medicine or caregiving — consider what chaplaincy offers your patients and families that the rest of the care team, however skilled and however caring, is not specifically trained to provide. We are not an add-on. We are not the person you call when someone is actively dying and you don’t know what else to do. We are most useful when we arrive early, when there is still time to accompany rather than only to witness. There is good reason that Medicare requires hospice and palliative care teams to include a chaplain alongside the physician, nurse, and social worker.
And if you are considering this work as a vocation — know that it will ask of and utilize all of who you are. Every loss you have carried. Every room you have been afraid to enter. Every question you have sat with that did not resolve. It will ask you to know yourself honestly enough to be present for someone else without making their crisis about you.
It is, in my experience, among the most demanding and most meaningful work a human being can do.
Father Mulcahy was a good man doing his best in impossible circumstances. So are most chaplains, of whatever gender. But the best of us are not defined by our collar or our tradition or our institutional role. We are defined by our willingness to enter the room, to stay without flinching, and to accompany another human being through whatever they are facing — with full respect for who they are, what they believe, and what they need.
That is what a chaplain is.
That is why you might want one.
Robert Drake is a clinical interfaith chaplain, death doula, eco-theologian, mediator and end-of-life educator with nearly twenty years of experience in hospice, palliative care, psychiatric, pediatric oncology, emergency medicine and medical aid in dying. He serves as volunteer Director of Spiritual Care Education for the Academy of Aid in Dying Medicine and works with individuals and families throughout the Pacific Northwest through Drake Living & Dying Design for grief and loss coaching individually and in group retreats. He is the originator of The Death Soiree. He can be reached at Support@DrakeLDD.com. #grief #loss #endoflife #medicalaidindying #chaplaincy