At least that's according to Rabbi Joseph Ozarowski, rabbinic chaplain at the Jewish Healing Network of Chicago and at Rush North Shore Medical Center and co-chair of the Chicago Jewish Chaplains' Group.

"Abraham is recovering from his circumcision" at an advanced age, "and G-d appears to Abraham. He visits him. G-d doesn't say anything to Abraham, he is simply there. That was the first bikkur cholim (visiting the sick) visit," Ozarowski says.

It might be a bit of a stretch, but today's Jewish chaplains, he says, do exactly the same things: listen and offer their presence.

Jewish chaplaincy may have started with G-d, but it's only in the last two decades that it has come into its own as a distinct, and crucial, specialty within the array of Jewish professionals. And it's a field that keeps on growing, chaplains say.

Chicago will temporarily become Jewish chaplain headquarters when the National Association of Jewish Chaplains (www.najc.org) holds its annual convention here on Jan. 20-23 at the Embassy Suites Hotel Downtown Lakefront. The theme of the conference, which will bring many of the organization's 600 members to the city, is "Family - Creating a Supportive Environment in Times of Need."

Participants will network and share ideas as they join in such sessions as "Mental Illness and Spirituality," "Aging Holocaust Survivors" and "Autism." At the closing session members will certify new chaplains and honor Rabbi Jack Frank, a Chicago spiritual leader who is considered one of the fathers of Jewish chaplaincy in the United States.

In Chicago, some 38 certified Jewish chaplains practice their trade, primarily at hospitals, nursing homes, assisted living facilities and other geriatric institutions and hospices. Their affiliation "is across the board - Orthodox, liberal, rabbis, not rabbis, men, women, Lubavitch - it transcends" such boundaries, Ozarowski says.

Across the country, Jewish chaplains also serve in the military, at correctional institutions, with police and fire departments, at colleges and universities and even, increasingly, with large corporations.

After the Virginia Tech campus tragedy last year, the NAJC was asked to send a chaplain to help meet the needs of grief-stricken students, faculty members and employees. The professional stayed for two months and still visits every two weeks.

Despite the profession's growing popularity and visibility, however, the words "Jewish" and "chaplain" have not always fit together comfortably.

"'Jewish chaplain' really was an oxymoron to a lot of Jews. It's only within the last 20 years, possibly less, that a lot of Jews have realized there is such a thing," says Rabbi Suzanne Griffel, chaplain at the Glenview-based Midwest Palliative & Hospice CareCenter and local chair of the NAJC conference.

Cecille Asekoff, the New Jersey-based national coordinator of the NAJC, notes that "there is not even a Hebrew word for chaplaincy. The whole concept of professional training for chaplaincy is called Clinical Pastoral Education, and the root of CPE is really the Christian church. Because of that the Jewish community was a little hesitant to jump on the bandwagon."

Griffel adds that in Israel, where the NAJC is involved with developing chaplaincy, "there is no commonly accepted word" for the concept. "We're working on trying to figure out a word," she says, with "spiritual support" and "spiritual accompaniment" being possible choices.

In another sense, though, Jewish chaplaincy is not new at all. "Judaism has always had a tradition of pastoral care," Ozarowski says. "It falls into the category of acts of loving kindness. The idea of visiting the sick, of taking care of the elderly and the needy is very much intrinsic to Jewish life. In the Torah, it isn't the job of the clergy to visit the sick, it's the job of every Jew."

Chaplaincy as a distinct profession originated with the military as far back as 1775, when the Continental Congress authorized the payment of army chaplains. The first chaplains were all Protestants, although thousands of Jews volunteered to minister to soldiers of both the Union and Confederate armies during the Civil War.

Finally, in 1862 Congress passed a bill allowing Jewish representation among chaplains in the armed forces. In both world wars, Jewish chaplains served not only Jewish soldiers but others who had no religious affiliation.

Gradually the occupation came to include professionals - mostly but not exclusively rabbis - who took over some of the specialized functions that rabbis often perform: providing "spiritual care," in Ozarowski's words, to people and families dealing with difficult situations, especially illness.

"The non-Jewish community has embraced the idea of clergy with specialized training taking care of the community, and we are picking up on this idea as well," Ozarowski says. "For rabbis, this has been something you do on the side. Over the last two decades at the most, chaplaincy and spiritual care has become a real professionalized subset of clergy work or quasi-clergy work."

Ozarowski himself became involved in the field through working on his doctorate, which dealt with bikkur cholim and bereavement. In 1995 he published a book on the subject, "To Walk in G-d's Ways: Jewish Pastoral perspectives on Illness and Bereavement" (Jason Aronson, reissued in paperback by Rowman & Littlefield Pub.).

Rabbi Frank, one of the pioneers of Jewish chaplaincy, recalls that as a synagogue rabbi, "it was part of my duties to go and visit people in the hospital. I took some training as a pastoral counselor and was appointed a chaplain for the now-defunct Illinois State Psychiatric Institute. That's where it all began."

He quickly found out that "unless a Jewish person was in the armed forces or in a hospital they basically don't know what a chaplain was, and those that did meet with a chaplain didn't know how to use them."

To help remedy this situation, the Jewish community called on Frank to develop certification requirements for Jewish chaplains that would put them on a par with chaplains in other religions. Since that time, "professionally I think we've made tremendous strides," he says while still decrying the fact that many hospitals in Chicago have little or no Jewish pastoral care and don't see the need to provide any.

Frank's push for certification and training has paid off. Today's Jewish chaplains are highly trained. Most, though not all, are rabbis. To be certified by the NAJC, a candidate must have a minimum of four units of Clinical Pastoral Education; a bachelor's degree or higher; either rabbinic or cantorial ordination or its equivalent (such as a master's in Judaic studies); and at least one year of experience in the field.

There are other requirements that are far less tangible. In providing "spiritual care" to patients and their families, Ozarowski says the chaplain must help to "find meaning from what they are experiencing and show them they are not alone. Not everybody is religious but everybody has spirituality. They need to know there is someone who cares, who can listen to them, journey with them, that there is an organized community that cares about them. This goes back to Torah, that it's the responsibility of a community to care, and the Jewish chaplain is the official representative of the community."

What this means in practical terms "depends on the situation," Ozarowski says, noting that chaplains do everything from praying with an ill patient to finding a menorah for lighting Chanukah candles.

"We don't come in with a script," he says, noting that even G-d didn't speak to Abraham when he visited him but simply made his presence known. "We're not trying to foist anything on (patients). We journey with them wherever they want to go. Our tools are our counseling and listening skills, our (knowledge of) ritual and halachah, our ability to connect with resources, to connect with family, or just what we represent. We represent G-d, Judaism, Torah, the Jewish community in their eyes."

While congregational rabbis have performed many of these functions historically, and some still do, "rabbinical training today doesn't really cover a lot of spiritual care," Ozarowski says. "Rabbis are not as highly trained as professional chaplains are. Most congregational rabbis don't have the specialized training for this kind of work."

The NAJC's Asekoff sees the Jewish chaplain as an integral part of the health care team, and says that in the last couple of decades "chaplaincy in general and Jewish chaplaincy have taken their rightful place within the health care team. Health care facilities and individuals are realizing that in treating and meeting needs we have to meet the patient's total needs, not only their health care, medical, emotional and medication needs but their total needs."

That, she says, includes spiritual needs. "A person is more than his or her illness," she says. "The concept of total care has come to be recognized in the health care field in general."

Jewish chaplains, she says, can be particularly helpful when dealing with the aging process and in cases where a medical cure is not in the cards. "We talk about the healing process, not the curing process," she says. "It's an integral part of medical centers and geriatric systems." In the concept of "aging in place," helping the elderly stay in their own homes, "the Jewish chaplain should be on the scene as well," she says.

One reason, chaplains say, is that they are trained to look at each person as an individual. "Clinical Pastoral Education has recognized the differences (among people), their ethnicity, which is very much in vogue today," Asekoff says. "We no longer look at people as the melting pot, we look at people with a total approach, as an individual with his or her own particular needs and traditions."

Healing is the operative word for the Jewish chaplains she works with as director of the Jewish Healing Network of Chicago, part of Jewish Child and Family Services, Tracey Lipsig Kite says. The agency, which provides such services as support groups, counseling, nursing home and hospital visits and help for chemical dependency, started in 2000 with two Jewish chaplains on the organizing committee , and chaplains have been instrumental in helping the network evolve, Kite says. There are now six chaplains on its advisory committee, a community group that helps provide direction for the agency.

"Jewish chaplains are on the ground doing a lot of Jewish healing, so it's natural we would have that close relationship," she says. "Jewish chaplains are out in the community doing a lot of the legwork. The Healing Network puts out a prayer pamphlet, but it's often the chaplains who are sharing the pamphlet with people in hospitals" and other facilities. "They're out in the world, in the field, doing the work and helping us understand more of the issues involved."

Professionals in the field stress that an individual or family doesn't have to be religious - or even Jewish - to take advantage of the services of a Jewish chaplain. Ozarowski, for instance, deals primarily with Jews in his work with the Healing Network, but at Rush North Shore, where he is on call at specified times, "it's whoever needs me," he says. Other hospitals, such as St. Francis in Evanston, have Jewish chaplains on staff who minister to both Jews and non-Jews.

It works the other way around, too. Ozarowski complains that Swedish Covenant Hospital, located in a Chicago neighborhood that includes many Orthodox Jews, doesn't have a rabbi or Jewish chaplain on staff.

In addition, he notes, the days when clergy would receive lists of patients' religious affiliation from the hospital are over, banned by HIPPA privacy rules. To visit Jewish patients rabbis must be accredited by the hospital and the patient must request a rabbi or chaplain.

Once they do, the services they receive vary greatly according to their needs. "We carry a spiritual toolbox with us, and sometimes we are surprised as to what they want from us," Ozarowski says. "Mostly what we bring is ourselves. We show them a love that is a reflection of Hashem's (G-d) love for them. We try to help them deal with their needs. There is often anger, pain, a lot of negative emotions."

A chaplain is not the same as a therapist, he points out, although there is some overlap. In Chicago, he says, "there are conversations between the spiritual health community and the mental health community," and he expects considerable cross-pollination to occur during the conference when participants from both areas discuss such issues as domestic violence, family systems and end-of-life issues.

The NAJC's Asekoff agrees that "what one really learns as a chaplain is to meet the person where he or she is, not to bring your own theological leanings or beliefs into the hospital room. A chaplain is here to help a person reach the decisions that he or she wants to, to talk through them and walk through them but not to be judgmental. A chaplain is not asked to render Jewish legal opinions."

Chaplains, she adds, deal with spiritual issues that "go beyond denominations. The 'congregation' of the chaplain is very diverse and challenging but doesn't reflect any specific theology."

It's a philosophy that Griffel, of Midwest Palliative & Hospice CareCenter, finds herself putting into practice every day as she works with the facility's clients, almost all of whom are dealing with terminal illnesses.

After working in several different area of the rabbinate, including as a congregational rabbi, Griffel has worked at Midwest for more than three years and says she finds chaplaincy "one of the most rewarding kinds of work I've ever done, tremendously rewarding."

"There are so many unique niches for a Jewish chaplain," she says. One is "to provide a link between the patient and family and their rabbi. Rabbis have so many different areas and concerns they deal with, they may not have the time or expertise to work extensively with patients. We can provide some extra hands and ears on the ground and help provide support for some rabbis for whom this might be daunting and difficult." She calls this "being an extension of the congregational rabbi."

While most all of her clients are Jewish, many are not religious and many others are unaffiliated with a congregation. With these clients, "I ask them, 'May I be your rabbi?'" Griffel says. "That establishes a very non-judgmental place to begin and shows them we're there for them if they're affiliated or not." She also sometimes works with non-Jewish clients when she is on call.

"We learn how to work with anybody of any faith or no faith," Griffel says. "One of the challenges as a Jewish chaplain is to be able to make an initial connection with a patient who is not religious." This is not always as difficult as it seems, she says, because "Judaism is so much more than religion - it's culture, history. That's important to bring to a relationship as well as more exclusively religious elements such as Torah study, prayer, Jewish songs or speaking Hebrew. There's a very big toolbox I'm able to draw from by virtue of being a representative of the Jewish people as well as the Jewish religion."

Then there are those patients who don't want to interact with a chaplain. Griffel doesn't push them. "It's their right, she says. "There is so much that's beyond their control, I want to give patients and their families back as much control as possible."

Griffel also faces issues some Jewish chaplains don't because she often goes into the homes of patients who are receiving hospice care. "It's a very rewarding component (of the job) to be allowed into someone's home, and we have to be respectful of their boundaries and their private space," she says.

Patients in hospice care, whether in their home, a hospital or a nursing home, form a growing constituency for chaplains, Griffel says. "Hospice is a growing phenomenon and it is essentially interdisciplinary. Nurses, doctors, social workers and chaplains all work together." Every terminally ill patient (some of the center's patients have life-limiting but not terminal illnesses) is offered the services of a chaplain, but not pushed to utilize those services.

Like other chaplains, Griffel stresses the fluid nature of the work she does. "One of the most important things to remember is that the work we do is really very broad. We are all trained to take our cues from the people we work with."

Chaplaincy might seem like a depressing profession to be in, but Griffel says her reaction is the opposite.

"The primary feeling I have is gratitude," she says. "I am so grateful that I am able to have these kinds of contact and access to these people. It's a tremendous privilege and every day I thank G-d for being able to do what I do.

"One of the main effects on my personal life is to help make me more aware of how lucky I am and to be grateful for what I have," she adds. "I live with a sense of being grateful, because I see so many people who have lost so much."

Griffel says that one of her favorite passages from Torah, and one that informs her work, is from the story of Hagar and Ishmael, when "G-d heard the cry of the boy where he was." That approach is one that she tries to take with patients, she says. "We journey with them."

With every new patient, Griffel and other chaplains perform an assessment to decide on the most fitting plan of care - not medically but spiritually. "No one should hesitate to take advantage of our services, or at least meet the first time," she says. "It doesn't matter what your background is," contrary to some patients' beliefs that because they are not religious or are not affiliated with a congregation or with the Jewish community, a visit with a chaplain would not be appropriate.

Chaplains are "very non-judgmental and pluralistic," she says. "We come to it with a completely open mind. Each patient and each family is a whole new experience. We're there for you wherever you are."