“What does a Department of Spiritual Care Services do?” a prominent theologian asked me early in the research for my forthcoming book Paging God: Religion in the Halls of Medicine. Troubled both by the apparent disappearance of religion from large academic medical centers and the use of “spirituality” as a place holder—at least in the titles—she was skeptical about what I might find and bothered by the consumerism she thought implicit in use of the word “services.”

The best answer, I discovered, is “it depends” and it does not always have a lot to do with whether the department is called Chaplaincy, Pastoral Care, or Spiritual Care Services. Building on growing attention to religion in health and medicine, use of the term “spirituality” began to increase in healthcare settings in the early 1990s from professional training to medical journals to patient care. Some chaplaincy departments—especially those on the west coast—followed the trend, changing their names to be symbolic of what they hoped was their more holistic and less predominantly Christian approach to patient care.

Today most of these departments—regardless of their names—staff chaplains from a range of religious backgrounds, including broadly humanist, who meet with patients and families throughout the hospitals. They tend to see the sickest patients—especially those dealing with end of life situations—offering their presence, a listening ear, and an approach that emphasizes the whole person. Many work around medical ethics. They also usually hold small services in their hospital’s chapels, prayer or meditation rooms in a range of religious traditions or that are broadly interfaith.

In their increasing embrace of spirituality as a way to describe themselves, their departments, and their work, hospital chaplains emphasize the “spiritual but not religious” meaning of the term spirituality. Such a connotation is common among people who reject organized religions in favor of their own personal ways of making meaning or relationships with the divine. While this rejection is not common among the chaplains themselves, they see the spiritual frame as a way to be as inclusive as possible in complex pluralistic medical settings. Their goal is to appeal to the broadest range of people they might work with in hospitals. Such efforts are premised on the belief that everyone has some sense of spirituality that the chaplains can tap into and work with in their interactions with patients and their families.

As sociologist Don Grant argues, this approach to spirituality views the concept as a “neutral—and perhaps more authentic—language that enables persons from different faith perspectives to exchange ideas on the sacred. Many, therefore, believe that spirituality—as opposed to organized religion—can communicate consensual meanings in a variety of corporate settings including hospitals..” The least common denominator approach to spirituality, often present in today’s large academic hospitals, glosses over differences in the ideas and practices central to different people’s notions of the concept. Instead, such a move emphasizes similarities. It remains vague, however, and makes the “communication of consensual meanings” a challenge as spirituality rarely means the same thing to the patients, families and staff members who hear the term and try to communicate about (or around) it.

Chaplains talk about the importance of presence, people’s stories, and making meaning in the context of illness. Medical staff more frequently speak of traditional religious beliefs and practices in a range of (their own) traditions. And patients and families speak a variety of languages about religion, spirituality and faith that sometimes overlap with those of the chaplains or medical staff and sometimes do not. Much is lost in the lack of easy translation as different people and groups—all speaking about spirituality in healthcare settings—do not always understand one another. Spirituality, then, is a weak shared language in large academic hospitals.

My throat hurts. If I tried to hum with the muezzin or call with the cats, it would hurt. I get up and take eight tablets of yin chiao from a friend who does acupuncture. It will, as she puts it, push the sickness back out through the skin. It worked the last time.

Later, I go out for more provisions, past the Baptist church with minarets; it used to be a Masonic temple. At Tony’s health food store I greet Khan who, like several sons of the owner, works there six days a week. I compliment him on his Om tattoo and he is delighted that I know about Shiva. I tell him that Shiva is actually very important to me and that Shiva Natajara is on my mantel and another Shiva adorns my Christmas tree. His face clouds over. “Wait,” I quickly explain why I think Shiva would be okay being a Christmas ornament. I redirect the conversation to finding broth. But now Khan follows me around the store, entreating me to take that ornament down. He keeps moving to front shelves in my vicinity and is now frankly warning about disrespecting Shiva. I feel like a total idiot religion professor.

On the way home, I pass churches of Pentecostals, Adventists, and Daddy Grace, as well as another masjid. It is February 3, 2011, and no one is surprised that someone walking around in Brooklyn would run into so many brands of religion. What might surprise is that the run-ins pierce and balm in so many ways. The neighborhood does this to some bodies and not others, I guess. But if you have a body that feels like the skin does not hold things in or keep them out, if you are made partly of memories of cuts and sutures, it might do this to you.

Religion is a chain of memory, says the sociologist Danièle Hervieu-Léger, and catholicité is a palimpsest. Bedford-Stuyvesant used to be all Catholic, and still the most and biggest churches are Catholic. Seven within ten blocks of my apartment. Now I pass one where a few women enter through the side door, the main door being locked on weekdays.

Thirty years ago, I lived far from Bed-Stuy, in a place where every town had a view of cornfields. Thirty years ago, I was going to school at St. Mary’s in Lebanon, Pennsylvania. Probably standing in a line. We were always in lines. Lines for changing classes, lines for going to lunch, lines for visiting the lavatory, lines for school assemblies, lines for going to Mass, lines for waiting for the bus at the end of the day. Lines on weekends, too. Line up for your heat at the swim meet. Line up for Rice Krispie treats at the bake sale table. Line up for confession. Line up for communion. In lines, you waited. Waiting was normal and so was the transaction at the end of the line.

But some lines were different, and you anticipated unusual things while waiting. In line to get ashes on your forehead, for example. There was always an emotional chill as the priest spoke mortal words about dust, and a physical flinch to feel fine black palm ash fleck the bridge of your nose. Or, in line to kiss the cross on Good Friday. Making sure to get behind Mrs. Viozzi who is ancient and four feet tall but still kneels on both knees and grasps the cross with both hands and kisses the wood with two full lips, a juicy smack that sounds across the whole nave. In line to have your throat blessed on the feast of St. Blaise…

Crossing Marcy Avenue now, I catch native son Jay-Z’s music blasting out an apartment window three stories up.

Can I hit it in the morning without givin you half of my dough,

and even worse if I was broke would you want me? …

If I couldn’t flow futuristic, would ya

put your two lips on my wood and kiss it, could ya…

I don’t know. Is love deeper than deep pockets? The neighborhood that used to be “Bed-Stuy/do or die” is now “Bed-Stuy/too late to buy” and churches turn into yoga studios at Washington Avenue.

Line up to go to the auditorium to see Jesus Christ Superstar. It was the monthly school movie some winter Friday in 1977. Eight years old, watching girls in sequined hotpants gyrate as the heavenly host, watching Yvonne Elliman as Mary Magdalene drag herself after wooden beams as if she herself were lashed to them, I wanted to dance, I wanted to be lashed, I wanted to kneel and kiss that wood.

When we lined up to get our throats blessed on the feast of St. Blaise, this too was different waiting for an unusual transaction. Frankly, it was scary. At the end of two lines advancing up the auditorium center aisle stood two priests. They each held a pair of thick white candles, tied together at a right angle to make a cross, and secured at the crux with red ribbon. When it was your turn, you stepped up and the priest held the crux at your throat and said, “Through the intercession of St. Blaise, bishop and martyr, may God preserve you from ailments of the throat and from every other evil.” Then, making the sign of the cross, you peeled away.

Scary. First of all, the wax against your neck was scented and tacky-cold and felt like a funeral. Then, why was this saint’s day of all saints’ days so important to take time out? Was there imminent danger to all human throats, as opposed to other body parts? Shouldn’t we also have blessings for eyes and brains and hands? I asked this. No. Only the throat. It made you think of things that could crush or slice you there. It made you pay attention to movies where after a quick yank and flash, someone’s jugular was spurting. It made you retain a vocabulary word like garrot. It made you notice when you had a sore throat.

Many years later, when I wasn’t in school and wasn’t going to Mass and the millennium turned and I just wanted to get through my first year of teaching, I still noticed in particular when I had a sore throat. In fact the one I got during finals week of that fall semester soon turned into a cough. But I was busy. And homesick. No time for a doctor’s visit. I left Texas for a trip back east. I wanted to see my family in Pennsylvania and my love in North Carolina. I packed it all into a mad visit with lots of long-distance driving. When I got back to Fort Worth, I felt much better.

Except I still had a cough, and swallowing had started to feel funny. Spring teaching commenced and I coughed through the first class. Finally I visited the doctor and was sent home with antibiotics. But that night my chest exploded with pain and my throat hurled back anything I tried to swallow. The next morning I presented at the doctor’s again. A more thorough exam revealed that some unknown problem had already resulted in severe pneumonia, one collapsed lung, a swollen heart lining, and infection blooming throughout my chest cavity. I was taken by ambulance to All Saints Hospital and did not leave for over a month.

The first two weeks, nothing happened. My sister Mary flew in from Atlanta and virtually moved into my hospital room. The chair of my department, Daryl, visited every day. Tests were run but no one could find the problem. Antibiotics slowed the infection but didn’t kill it off. A brown bacterial stew that smelled like raw sewage had begun to burble up into my mouth. One day, finally, it started to drown me. Mary and a friend, Leah, frantically alerted the nurse. I lost consciousness as doctors cut notches between my ribs on both sides to insert chest tubes. When I woke up, I was in the ICU, lung fluid still draining into canisters on the floor.

My doctor would come see me and talk. His name was Noble. Noble Ezukanma, internist, point person for an array of specialists. Nigerian, Christian, married with three kids, beautiful and wise. I asked him all the questions I could think of. “This diagnostic process, we are trying things, you know, but it is really more an art than a science,” he would say. “We have to wait.” He didn’t know how things were going to turn out. He said so. He was an artist in process. It was comforting.

But it was another doctor who arrived early one morning, when I was alone, to tell me that one test had finally nailed it: prolonged coughing—or a fishbone accidentally swallowed, or vomiting, or chance?—had torn a hole in my larynx. Everything I ate or breathed was feeding the infection. They required my signature for surgery. Immediately.

What happened next, I am not sure how. I was frightened and teary plus high on morphine. Did I remember what day it was? Did Daryl somehow know? Did the hospital chaplain staff piece it together despite no checked box on the intake form? I don’t know. But within a few hours, Daryl had brought the campus priest to my bedside. Fr. Charlie carried two white candles, crossed and tied with red ribbon. It was February 3, 2001, and I got my throat blessed.

So, as you see, were it not for St. Blaise, I would not be here to tell you this story. I would not have returned to my classes that semester, would not be chewing over the meaning of spirituality for an online collection, would not be remembering waiting in lines, would not be walking home from Tony’s in Bed-Stuy with good broth for a sore throat.

But wait … this is no way to end the story. Don’t mess with people, people in the guild, my guild, my people. Don’t mess with my head. Leave out suggesting that St. Blaise was actually involved. Leave out hinting that without St. Blaise I would be dead. It was doctors who operated and sewed me whole. If St. Blaise supposedly saved my life, then why didn’t all those blessings years earlier work? If I am having a fit of wanting to thank a saint, I can do it on my own time. Would I say this stuff in the classroom? Do I really believe … ?

I do believe … in religion as a social construction with a long history, and in spirituality, too, begotten not made, one in being with religion. And in experience, and the self, and pluralism, and God, and any story any of us could possibly tell, all of them truly assumed, asserted and produced in very complex genealogies. Credo.

But sometimes I forget to care. My skin does not hold things in or keep them out. And having this kind of body—a body of memories of cuts, not all my own—goes back long before the hospital, long before I was born, long before St. Blaise himself. Still, I have faith. Tell the children that they can see through the powers that be. Tell the children that they can choose to believe this and not that. Tell them that their bodies are theirs for the making. That if something goes wrong the doctors can slice through layers and suture back out and then you are whole again.

Yet I keep bumping into religions and they don’t bounce off. Why live? Why sicken? Why call for ravishment? Why calm at the touch of red-ribboned candles? I have nothing against stitches. The rows run across my neck and over my heart. There are little crosses that closed chest tube holes and a big stripe under each shoulder blade. They saved my life. But some bodies are pounds of flesh with oozing edges and no fix for that. Meanwhile, I teach, I write, I walk around and see what happens. “This process, you know, we are trying things, but it is more art than science,” the good doctor said. “We have to wait.”