The ambivalent chaplain: negotiating structural and ideological difference on the margins of modern-day hospital medicine.

The chaplain experience in modern-day hospital medicine is largely one of marginalization. It is not, however, an experience without agency. Working within the constraints of difference, chaplains learn how to negotiate on the margins of medicine. This starts with learning the language of hospital medicine, learning to skillfully see, speak, and move in ways that minimize difference. Successes in socialization and acclimation do not, however, guarantee the chaplain a place in the hospital, where chaplains encounter both structural marginalization (resulting from inequalities in power and hierarchy) and ideological marginalization (resulting from inequalities in accepted forms of knowledge and practice). Using the theories of Michel Foucault (1973) and Byron Good (1994), I examine how chaplains negotiate structural and ideological marginality, at times embracing their connection to medicine (downplaying their connection to the institution of religion) and at other times embracing their connection to religion and religious practices. The result is an ambivalent chaplain who strategically embraces one or the other paradigm in order to survive. Using data gathered during a 12-month ethnography of chaplain interns at a university teaching hospital, this article examines the structural and ideological differences between science and religion through the modern-day practice of hospital chaplains. It both introduces readers to the modern-day chaplain, a healer largely absent in ethnography, and adds a renewed perspective to a long-standing body of literature on the relationship between structure and agency, and science and religion.