01/28/13

Patients, doctors, and the power of religious faith

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By Dr. Suzanne Koven

In the lobby of the hospital where I did my medical training stands a 10½-foot marble statue of Jesus. Patients and visitors often pause before the imposing figure to gather their thoughts, pray, or just touch its smooth white foot. The hospital has always been secular, but the statue has brought comfort to thousands for over a hundred years. It also reminds doctors that, in medical matters, our patients do not necessarily see us as the final authority.

praying_handsSeveral surveys show that over 90 percent of Americans believe in God. It’s not surprising, then, that religion plays an important role in medical care. Just as there are no atheists in foxholes, a nonbeliever might reconsider while being rolled into the operating room or waiting for a biopsy result.

The clinical efficacy of prayer is difficult to measure, though researchers have tried. In one study, strangers were instructed to pray for patients undergoing heart surgery. The prayers did not seem to improve the patients’ outcomes. Interestingly, if the patients were told they were being prayed for, they had more postoperative complications.

Still, there’s no question that prayer benefits many people. Prayer, like meditation, can lower blood pressure and anxiety and put patients in a more positive frame of mind. Even doctors like me who are not religious appreciate the element of mystery in medicine; an unexplainable force that seems, at times, to aid recovery. I was discussing this recently with a patient of mine who is a nun. She pointed out that what I call a coincidence she calls a GOD-incidence — even though we might be talking about the same thing.

On many occasions I have found myself humbled and inspired by my patients’ religious faith, even when I did not share it and even when it did not produce a cure.

One devout woman in her 50s who was dying of uterine cancer made an appointment with me to discuss what she had only identified on the phone as “plans.” I assumed she meant hospice care, DNR orders, and pain management. But what she had in mind was none of these. She told me, matter-of-factly, that she had no fear of death, that she fully expected to be reunited in heaven with her late father, and that she looked forward to this.

She did, however, have some loose ends to tie up before then, including arranging for the care of her mother, an elderly woman who was also my patient. In a very organized and business-like way she told me that she intended to move her mother in with a cousin, and enlisted my help in transferring her medical care to a physician closer to her new home — or, her next-to-last home, the one she’d inhabit before she too arrived in heaven.

I found myself full of admiration for this woman, and envious of her, too. I could not imagine having this kind of equanimity myself, faced with a hereafter about which I did not share her certainty. I had to admit that God offered her more beneficial “end-of-life counseling” than I ever could.

Another time, I found myself in a diagnostic dispute with God. A middle-aged woman developed a series of neurological symptoms. Neither I nor several specialists could determine their cause. The patient, on the other hand, was quite sure that she had chronic Lyme disease. She’d had a divine vision one night, in which the word LYME appeared in large letters. For a few years she took antibiotics continuously, prescribed by a doctor who treats chronic Lyme.

Unfortunately, her symptoms progressed, and she ultimately proved to have ALS, or Lou Gehrig’s Disease. After the woman died, I reflected that while her vision had been misleading, it had brought her hope during the last years of her life — hope that she would not have enjoyed if she’d known from the start that she had ALS.

Occasionally, even I wonder if an event can be purely coincidence.

Years ago, I headed out of town on vacation, neglecting to tell a hospitalized patient of mine that I would not see her for several days. I had arranged for one of my partners to care for her, of course, but worried about whether she would feel I’d abandoned her. This was before the era of cellphones, and the pay phone at the seaside motel where I was staying was broken. I decided that it really wasn’t necessary to call my patient and went for a walk on the beach.

By the water, coming toward me, emerging through the bright sunlight, was a man wearing a T-shirt with a single word imprinted on it: my patient’s last name. I left the beach and found another pay phone. She was doing fine, and was happy to hear from me.

My patient the nun once asked if I might visit her mother, also my patient, at home when the older woman was near the end of her life. She asked if I would draw her mother’s blood during my house call.

I was a crackerjack phlebotomist back when I was an intern, but it had been years since I’d drawn blood and told her I might be rusty. That was OK, she said. She had faith in me.

I dusted off my black doctor’s bag, threw in a needle, some tubes, alcohol wipes and a tourniquet, and headed to my patient’s house. When the time came to draw the woman’s blood, I had trouble finding a vein.

“You can stick her again if you need to,” said the daughter kindly. I confessed that I’d brought only one needle.

“Then, doctor,” said the nun, “I will pray for you.”

I adjusted the needle slightly, and a flash of red appeared. I turned to the patient’s daughter, seeking her approval. But her eyes were not on me.

They were lifted to the sky.

Complete Article HERE!

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01/24/13

Last week in Grafton: a research story

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Caring at end of life is an innovative research project that has a real interest in people who are supporting loved ones who have come home to die. We are interested in what you have to say as a friend, family member, neighbour, work mate, service provider and community member of a dying loved one.

Caring at end of life

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01/23/13

Hump Day Humor

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Holy cow! I missed the last couple of hump days.  That’s not good!

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01/21/13

Mitch Carmody’s Review

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I’m honored to share with you a remarkable new review of my book by an equally remarkable man, Mitch Carmody, CGSP. He is the author of Letters to My Son, turning loss to legacy.

The Amateur’s Guide to Death and Dying: Enhancing the End of Life
By Richard Wagner, Ph.D., ACS

I found Dr. Wagner’s book to be an incredible expose’ on the processes and mythologies of death and dying in a modern world. It was wonderful, refreshing, educational and enlightening, as well as entertaining.AGDD_front cover

The colorful cast of round table characters that he created from a compilation of real life people is quite remarkable; by the end of the book I had my favorite personas that I could not wait to hear from. The book engages you right from the get go and maintains that momentum throughout its pages. It made me laugh, it made me cry; it validated and put into simple words so may ideologies that I subscribe to in processes grief and facing one owns mortality.

This book is perfect for those individuals that may not like to attend or who are unable to attend a support group. For people faced with their own impeding death, this book is a brilliant concept. It allows for group interaction without actually being present.

This book is not only great for the dying and terminally ill but for caregiver, family and clergy who serve their needs. I highly endorse it and would recommend it to anyone seeking theological enlightenment. We are all amateurs when it comes to death and dying, for ourselves or those whom we love. Reading this book gives one encouragement to step outside the box of accepted social mores about death and dying and I believe can truly enhance the end of life for those faced with their own death. A great read for anyone; not one of us will escape from the eventual reality of our own death or those whom we love. This book can prepare us.

Mitch Carmody, CGSP
Author of Letters to My Son, turning loss to legacy
Creator of Proactive Grieving ©
www.heartlightstudios.com
www.proactivegrieving.org

Heartlight Studios

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01/15/13

Is Death The Enemy?

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“In the end, the marginal status our culture assigns to the end of life, with all its fear, anxiety, isolation and anger is inevitably what each of us will inherit in our dying days if we don’t help change this unfortunate paradigm.”

 

For many healing and helping professionals, death is the enemy. That doesn’t come as much of a surprise really. Everything in our training, as well as everything in our culture, underscores that mindset. But this principle can actually be counterproductive more often than we realize. I am of the mind that if we encounter our mortality in an upfront way, we will be able to demonstrate genuine compassion to our patients and clients as they face theirs.hospitalbed

Here are some things we might want to consider if encountering mortality is our goal:

  • Death isn’t only a universal biological fact of life, it’s also a necessary part of being human. Everything that we value about life and living — its novelties, challenges, opportunities for development — would be impossible without death as the defining boundary of our lives.
  • While it may be easier to accept death in the abstract, it’s often more difficult to accept the specifics of our own death. Why must I die like this, with this disfigurement, this pain? Why must I die so young? Why must I die before completing my life’s work or before providing adequately for the ones I love?
  • Living a good death begins the moment we accept our mortality as part of who we are. We’ve had to integrate other aspects of ourselves into our daily lives – our gender, racial background, and cultural heritage, to name a few. Why not our mortality? Putting death in its proper perspective will help us appreciate life in a new way. Facing our mortality allows us to achieve a greater sense of balance and purpose in our life as well.
  • Dying can be a time of extraordinary alertness, concentration, and emotional intensity. It’s possible to use the natural intensity and emotion of this final season of life to make it the culminating stage of our personal growth. Imagine if we could help our sick, elder, and dying clients and patients tap into this intensity. Imagine if we had this kind of confidence about our own mortality.

We healing and helping professionals can actually help pioneer new standards of a good death that our patients and clients can emulate. We are in a unique position to help the rest of society desensitize death and dying. And most importantly, we would be able to support our patients and clients, as well as those they love, as they prepare for death. We could even join them as they begin their anticipatory grieving process.EndOfLifeCareSOS024HIRESsmall

If we face our mortality head-on we will understand how difficult it is for our sick, elder, and dying patients and clients. We will be more sensitive to their striving to regain lost dignity by actively involving themselves in the practical preparations for their own death. If we can project ourselves to the end of our lives we will better understand our patients and clients as they try to negotiate pain management, choose the appropriate care for the final stages of their dying, put their affairs in order, prepare rituals of transition, as well as learn how to say goodbye and impart blessings.

Facing our mortality may even allow us to help our patients and clients learn to heed the promptings of their mind and body, allowing you to move from a struggle against dying to one of acceptance and acquiescence.

In the end, the marginal status our culture assigns to the end of life, with all its fear, anxiety, isolation and anger is inevitably what each of us will inherit in our dying days if we don’t help change this unfortunate paradigm.

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