After a few weeks away from the hospital, I came in to find Clark, a man in his early 60s, on my unit.  He’d had a complex set of medical problems, including cancer, that had had him fighting for his life in the ICU for a couple of weeks.  He’d stabilized enough to be moved to the oncology floor a few days earlier, but he’d remained in a state of delirium—until that morning.  His chart indicated he’d now been fully briefed on his course of care over the previous weeks.  Palliative care options had been discussed, and he was still taking it all in.  I let a few more hours go by, then went to see him in the afternoon.

“Greetings, Clark, my name’s Greg, and I’m one of the chaplains here …”

He cuts me off with a smile.  “I’m an atheist.”

“I saw that on your chart.  Many of my family and friends are atheists.”  I return the smile.  “I’m here to offer company and conversation to anyone who wants it, with no regard to religion.”

“Oh …”  Clark pauses for a moment, thinking.  “I’d like that, actually.  It’s been a big day for me.”

“Seems like it.  Tell me more.”

“Well, I feel like myself for the first time in ages, and I’ve had time to sit and think.  I’ve decided I’m done with medical treatments.  The last few weeks have been hell, and I still have stage IV cancer.  I don’t want to keep doing this—I’m done.  I’ve had a really good life, and I’m not afraid of dying—I’m ready.”

“Wow, that’s big all right.  You sound really clear about this.”

“I am.  The more I sit with it, the more it feels right.”

“Then I’m very happy for you.  Would you like to share a bit about the really good life you’ve had?”

Clark’s face lights up.  “I’ve been a high school science teacher my whole life.  I just love science—that’s why I’m an atheist.  I was raised Jewish, but I can’t reconcile the idea of God with my own understanding of the universe.  I don’t think it works that way, and I don’t need it to—I find all the beauty and meaning I need in the natural world.”

“I love your enthusiasm—no wonder you are a teacher!  Tell me, if you don’t mind … have you been thinking about what comes next?”

“I’ve always thought there is nothing more to us than the molecules we are made of,” Clark continues.  “Yet what an amazing thing it is that our consciousness, and our ability to think—and do science, and have relationships—arises from just these molecules.  I like thinking of myself as made of the same matter as the universe, and I’ll just be giving that matter back to the universe when I die.”

“That’s a beautiful image, Clark.  For me, the essence of spirituality is a sense of oneness with that place from which we were created, our ability to feel and express wonderment and gratitude, and our care for our fellow created beings.  Whatever you call it, you’ve got it.”

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There was much more to my conversation with Clark than just this snippet, but this is what opened the way forward.  I never begrudge a patient’s preconceived notions about why a chaplain might knock on their door—one never knows what they’ve experienced that formed those notions.  If given a chance, my goal is always to defuse their preconceptions by simply stating what we do, then let them decide from a better-informed place.  I’m grateful that Clark, scientist that he is, took what I said at face value and accepted my offer.

The majority of patients I see in the hospital have no active religious practice, and even fewer participate in a religious community.  Many still feel a sense of identity with religious roots from their upbringing or families of origin, but have left that behind—just like Clark.  All of this is in keeping with trends that have been evolving since at least the 1950s; for better or worse, Portland is farther along the path than most of the U.S., but it’s happening everywhere.

Those without religious identification often search for a label to communicate their status: atheist, agnostic, none, and “spiritual but not religious” are ones I hear frequently.  But all labels are inadequate, including Christian, Jewish, Muslim, Hindu, Buddhist, and Quaker—we are all unique manifestations of what it means to be human.  So when someone offers me a label, I see it as an invitation to learn more about what that label means to them.  If they want to be known, they are usually happy to say more, and that’s when the real conversation begins.

This sentence leapt out for me from an article I read recently:  “The quest for certainty and control can tempt people of every faith and no faith.”^[1]  I have listened as patients expressed their certainties in times of crisis—whether grounded in religious dogma or in scientific determinism—and I do my best to support them in whatever context they find solace.  But true faith, for me, is the opposite of certainty:  it is the embrace of all that we don’t know, coupled with a set of beliefs that enable us to step forward toward the unknown.  In this sense, Clark was every bit as much a person of faith as any religious person I have ministered to, in spite of his self-described “atheist” label.

With labels set aside and a lovely foundation beneath us, Clark and I discussed the many other important things on his mind:  how best to convey his decision to his life partner, who would be arriving in an hour; whom he might want to reach out to before he passed; how he would like to be remembered by the school and students he had given his life to—and how a hospice chaplain could continue these conversations with him after his discharge from the hospital.

I am blessed to have known Clark.

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[1] “‘Shiny Happy People,’ Fundamentalism and the Toxic Quest for Certainty,” NY Times, June 13, 2023,