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Faith and Medicine: A Growing Practice

Knowledgeable roofers begin the roofing process.
Illustration by Julie Lonneman


Medical students now learn about the links between religion and health, how to take spiritual histories and how to examine ethical issues.

By Jay Copp

 

Age-old Fears

Acceptance Increases

A Tradition of Caring

Science and Spirituality

Resistance Remains

The Spiritual Dimension

Sidebar: Do Mergers Change Catholic Hospitals' Identity?

Delivered nearly five months early, Shel’be Pruitt weighed 17 ounces. She suffered from pneumonia, and her heart and lungs were barely large enough to work. Steven and Shaunte’ri Pruitt prayed day and night for their daughter. Doctors and nurses at Loyola University Medical Center, near Chicago, even as they used the latest technology to treat Shel’be, advised the parents that prayer was indeed a valuable resource.

“It’s such a religious place,” says Shaunte’ri, a devout Baptist, about Loyola. “So many people said they were praying for us. One of the doctors put it best. He said, ‘Shel’be will tell us whether she wants to go to heaven.’”

Born in July 1998, Shel’be went home after a four-month stay at Loyola. She is doing well and so is Loyola in its goal of treating the human spirit. Its medical school is one of a growing number of U.S. medical schools which advocate attending to the spirit as well as the body. Especially at Catholic schools, medical students are taught to address patients’ spiritual concerns.

For many people, modern medicine in the United States lacks heart and soul. Patients complain of being mistreated by profit-driven managed care and hurried doctors. The golden age of medicine, in which family doctors knew their patients and emitted warmth and solicitude, is viewed as long gone.

A patient today can feel like a number, poked and prodded like a malfunctioning machine. But Catholic medical schools are leading the charge to restore health to the practice of medicine. Medical school students learn that much more is going on inside a patient than a faulty heart or balky limb.

“When a person has a serious or chronic illness, God becomes very important,” says Dr. David Larson, president of the National Institute for Healthcare Research (NIHR) in Washington, D.C., a nonprofit group that studies the link between faith and healing. “Medicine can offer patients a lot. But we don’t necessarily offer hope. We don’t offer love very well. We don’t offer meaning. Guess what does?”

Age-old Fears

Loyola University Medical Center and its Stritch School of Medicine occupy a 70-acre campus in Maywood, Illinois. The center, a testament to the power and glory of modern medicine, has the oldest and most active heart-transplant program in the nation. It performs the most bone-marrow transplants, lung transplants and cornea transplants in Illinois. Its “flying emergency room” helicopter saves people whose fate would have been sealed without its traffic-defeating transport.

Amid the marvels of modern medicine found in every patient’s room are the age-old fears that accompany illness. “We teach our students that every serious illness presents a crisis of meaning,” says Maureen Fuechtmann, associate vice president for university ministry at Loyola. “This ranges from simple fear to who will take care of my kids to a person’s sense of vulnerability. We become more serious about God when we’re ill. We start to understand our own fragility. We maybe understand there is a God and it’s not me.”

Seriously ill people frequently experience a heightened spirituality. In a study of 200 elderly patients in Kansas City, 91 percent said their initial response to a new medical problem was prayer. A study of patients awaiting heart surgery found that 96 percent used prayer as a coping mechanism. The awakening of spirituality relates to theologian Martin Buber’s conviction that “God culminates in the present moment.” God is part of all human experience. The ill intensely experience God’s presence even if they are not conscious of it.

“The spiritual issues [regarding the sick] are related to relationships,” says Linda Bronersky, a chaplain at Loyola. “There are issues of grief and reconciliation. There might be unresolved anger....People have time to think and reflect. They remember losses. They miss people.

“When most people are in crisis, the spiritual side rises up. They’re in touch with a power greater than themselves.”

Loyola’s curriculum in spirituality and medicine spans a medical student’s four years. Loyola students spend time at hospices and assisted-living homes. They learn how people endure long-term illness, chronic pain and dying. Courses examine end-of-life concerns and reproductive issues. The curriculum at Loyola, which enrolls Catholics and non-Catholics, promotes respect for Jesuit and Catholic traditions, as well as other religious traditions.

Students also make rounds with chaplains. It is then that they hear patients talk about their fears and worries. The experience will help future doctors handle the most sensitive situations they will face, including death.

Aveen MacEntee, then a first-year student, vividly recalls one of her rounds with a chaplain. The chaplain told the heart patient he would not make it. The patient was stunned; his wife and children were crushed. “I never experienced anything like that. I saw how the news created this wave of effect in his family,” says MacEntee, a first-year resident in internal medicine at the University of Chicago.

For MacEntee, the training struck a nerve. As taught, she quietly takes a “spiritual history” when taking a physical history. Is there someone the patient relies on in a crisis? Is the person’s mother or father still alive? Is the patient’s job going O.K.? She tries to establish a personal connection. “A really good doctor cares about a patient as a person,” she says. “I tell myself that this is someone’s mother, someone’s sister, someone’s child.”

There is an indication that the curriculum is succeeding: Third- and fourth-year Loyola students are making more referrals to chaplains than students of years past did. Doctors nationwide generally fail to alert chaplains to patients in need. “We say we do it, but we don’t,” says Larson. “In all my years of medical school I didn’t even know they existed.”

Loyola received a grant from NIHR to implement spirituality courses, as did other schools including Georgetown University’s School of Medicine in Washington, D.C. Medical students there learn about studies linking religion and health, how to take a spiritual history and examine ethical issues.

Acceptance Increases

The U.S. medical community is increasingly receptive to linking faith and medicine. “Ten years ago this [the acceptance of faith and medicine] would have been unthinkable,” says Dr. Dale Matthews, an internist and associate professor of medicine at Georgetown. “Five years ago there was a murmuring in the medical community. Today, it’s largely accepted.”

In 1995, Spirituality and Healing in Medicine, a conference sponsored by Harvard Medical School, drew nearly 1,000 health-care workers. A survey taken in 1996 by the American Academy of Family Physicians discovered that 99 percent of family physicians believe in the ability of religious beliefs to contribute positively to medical treatment.

Today, more than a third of the nation’s 125 medical schools offer courses in faith and medicine, a remarkable change from a few years ago when only a handful did. Catholic medical schools, though initially slow to adopt faith-and-medicine curricula, now lead the pack, says Larson. The policies of Catholic hospitals and medical schools significantly affect health care in the United States: Catholic hospitals are the nation’s largest nonprofit health-care providers.

Supporters of faith-and-medicine initiatives note that young doctors instinctively want to relate to the human spirit but often shed that approach over time. “Most people come to medical school as whole, complete persons,” says MacEntee. “The process changes you. You forget about the way you were. You come up with defense mechanisms to deal with all the suffering you see.”

Even before finishing school, students become “medicalized,” using medical jargon with patients and losing the ability to relate to them as people, says Jesuit Father Myles Sheehan, a doctor who is the course director of Loyola’s spirituality and medicine curriculum.

The medical community’s traditional resistance to spirituality reflects this country’s outlook on privatization of spirituality and religion. Matters of the spirit are pushed aside. As Rabbi Marc Gellman once observed, “The last socially acceptable prejudice in America is prejudice against those who take their faith seriously.” Medicine, understood as a branch of science which shuns religion, historically has kept spirituality at an arm’s length.

A Tradition of Caring

In contrast to modern medicine, the Catholic tradition in medical care is deeply rooted in the spirit. That makes perfect sense, given that Jesus cured the ill while proclaiming the Kingdom of God. Jesus alleviated suffering as a sign of God’s goodness and power entering the world. Faith itself was enough to effect a cure.

Mark’s Gospel (5:25-34) tells of the woman who reached out to touch Jesus’ robe. The biblical passage that is the scriptural foundation for the Sacrament of the Anointing of the Sick (James 5:14-15) suggests a link between healing the body and healing the spirit.

In early Christian communities the sick were cared for in their homes by deacons and deaconesses, according to historian Christopher Kauffman. Baptism and the Eucharist were viewed as having a curative effect on the sick.

After the legalization of Christianity in the Roman Empire, Christians founded hospitals. One of the most notable was the one started by Basil the Great around 372 in Caesarea in his diocese of Cappadocia. Later, Benedictine monks included infirmaries in their monasteries. These evolved into hospitals.

Other religious communities sponsored hospitals, a practice that continues today. From its earliest days, Christianity transformed society’s care of the sick, says historian Henry Sigerist. Ancient Greeks and Romans who took care of the sick and poor did so because of a “civic philanthropy,” rather than charity based on love.

Christianity was the religion of healing, the religion of the Redeemer and of redemption. Christians reached out to the suffering to heal the spirit and body. The early Christians believed, as we do, that people are made in the image and likeness of God and possess an inherent dignity.

Christianity infused health care with a spiritual underpinning. Body and spirit are inextricably linked. Taking care of the sick is imitating Jesus. As St. Vincent de Paul told his Daughters of Charity, “When you leave your prayers for the bedside of a patient, you are leaving God for God. Looking after the sick is praying.”

Medical schools that teach the link between faith and healing are reinforcing the age-old notion that medicine is God’s work. That notion predates even Christianity: “Hold the physician in honor, for he is essential to you, and God it was who established his profession” (Sirach 38:1). Catholics today understand medicine as a vocation. “What we do as physicians caring for patients is intimately related to spirituality,” says Sheehan. “What we do is a manifestation of God’s healing power. Taking care of the sick is part of the Kingdom of God.”

Science and Spirituality

What does science say about the relationship between body and spirit? The results of several hundred published studies show a link between religious commitment and better health, says Larson. Among the studies:

  • Researchers at Duke University found that people who attended religious services at least once a week and prayed and studied the Bible had consistently lower blood pressure than those who did not. In fact, regular participants in religious activity were 40 percent less likely to suffer diastolic hypertension, associated with heart attacks and strokes.

  • A study of patients undergoing elective heart surgery showed that six months after surgery the death rate was significantly lower among churchgoers as compared to non-churchgoers.

  • A study of depressed, medically ill older adults found that the more religious a patient was, the more quickly he or she recovered from depression. (Recovery from serious physical illness is often prolonged by depression.)

  • Among cardiac-transplant patients, those who often prayed to God and regularly attended church services recovered better physically and emotionally. Says Dr. Matthews, author of The Faith Factor: Proof of the Healing Power of Prayer, “Faith is good medicine. The medical benefits of faith are not a matter of faith but a matter of science. People with a strong religious practice experience better health.”

The positive effects of religion can be explained without reference to the supernatural, says Matthews. Religious practice is beneficial physically, socially, psychologically and in terms of life-style. Churchgoers enjoy more social support than non-churchgoers, reach out for help more often and with more success, follow a less risky life-style and possess a greater ability to cope with stress.

Some studies on health and healing, though, suggest a divine influence. A 1988 study of 393 patients in a coronary-care unit in San Francisco revealed the positive effect of intercessory prayer. Patients for whom a prayer group prayed had more favorable outcomes than patients who were not prayed for.

Faith and health are woven into Christian history. Matthews believes in both the natural and supernatural power of faith. “I believe in a God who intervenes,” he says. “By definition, a person of science can’t make that claim. As a person of faith I can.”

The Gospels recount the power of God over illness. No less than 35 instances of healing occur in the Gospels. The holy men and women who came after Christ and who are now saints performed miraculous healings.

Miraculous healings are often understood as bolt-of-lightning phenomena. They may be or can be understood as growing out of the unity of body and spirit. God became flesh, and all flesh is sacred and capable of restoration and regeneration, even beyond doctors’ original diagnoses. The Holy Spirit works through people, bolstering their ability to cope with stress, live a less risky life-style and conquer disease.

Sometimes God works in not-so-mysterious ways. The challenge is for health-care professionals to honor the spirit while examining and treating the body. “They need to know what’s going on in patients’ lives,” says Sheehan. “It’s not as if they should be holding hands and praying with patients....Spirituality is not something that belongs only to chaplains. There needs to be an awareness of the presence of God in the world around us.”

Resistance Remains

Despite the wealth of studies on faith and health, many in the medical community still resist seeing the link between the two, says Larson. Some health-care professionals dismiss the findings as “bad science,” even though studies on religion, given the controversial nature of the topic, are subject to intense scrutiny. Public-opinion polls show that 80 percent of Americans believe in the power of God or prayer to improve the course of their illness. Yet only 10 percent of physicians inquire about such beliefs.

Larson recommends that health-care professionals approach their patients in a nonthreatening, sensitive way about spirituality. “They can ask, ‘Is God important to you?’ If they say no, stop right there.”

Patients nearing death, facing major surgery or battling drug or alcohol abuse often want doctors to address spiritual issues. “Doctors are in the business of helping people,” says Matthews, who sometimes prays with patients. “We warn them not to smoke or drink. We tell them to exercise. We can certainly talk about what brings them peace and joy, what is the meaning and purpose of life.”

Health-care professionals who attend to the spirit can quicken recovery. Patients who are comfortable enough with a caregiver to talk about an inner crisis, besides the relief of unburdening themselves, may share critical health-related information.

“It helps if when a doctor walks into a room he doesn’t start asking medical questions right away,” says Bronersky. “The relationship between illness and stress isn’t completely understood. But if a doctor can hear the various stress factors in a person’s life, that can help a person to heal.”

Linking faith and healing also benefits society by reducing health-care costs. A study showed that those over 60 with a religious affiliation who were admitted to a hospital averaged 10 days of hospitalization over the next year. Those without a religious affiliation averaged 60 days.

Critics say that doctors ought to stick to medicine and leave spirituality to chaplains. Responds Matthews, “Chaplains are very important and we need to walk hand in hand with them. But there are not enough chaplains in the world to deal with all the problems we encounter.”

The Spiritual Dimension

The 70’s were tagged as the Me Decade, and the 80’s as the time of yuppies and materialism. But today in medical schools and hospitals, bastions of science, new attention is being paid to the spirit. “In the 70’s and 80’s, the spiritual in our culture was not talked about,” says Bronersky. “There’s been a rebirth of it.”

Doctors and nurses at Loyola pass by a sign on a wall that says, “I Was Ill and You Cared for Me.” Curing can hardly be done without caring. Health-care professionals are heeding spiritual vital signs. Treating patients is “like reading a biography,” says Fuechtmann. “Not understanding the spiritual dimension is like skipping a chapter of the biography.”

Former patient Deborah Ross-Greene attests to the value of the spirit. Last year Loyola became her second home as she waited for and received a heart transplant. A chaplain visited often to talk and pray. She grew close to a fellow patient who also needed a transplant. After the man died, nurses sympathetically hugged her and doctors visited to comfort her. After her successful surgery, she joyously hugged her doctor. “My fate was decided by God,” she says. “God shared that with me through the doctors. I put my health in their hands.”

Do Mergers Change Catholic Hospitals' Identity?

Catholic hospitals are paying more attention to treating the whole person. Health care’s increasingly competitive market, however, has led to sales, mergers and closings of Catholic hospitals. Consequently, some people no longer have access to a Catholic hospital or are served by a hospital whose Catholic identity is compromised. Some Catholic hospitals are partners with health systems that permit sterilization and dispensation of birth control, practices banned inside Catholic health facilities.

Ten U.S. Catholic hospitals in the last two years have been sold to for-profit hospitals. Eighty-four Catholic hospitals have entered into partnerships with non-Catholic health systems since 1991. Others, unable to survive, have closed their doors. Overall in the last decade, the number of Catholic hospitals has declined from 641 to 601.

The local bishop can revoke a hospital’s Catholic identity if it is warranted because of its sale to or partnership with a non-Catholic health system. This rarely happens; rather, non-Catholic hospitals that merge with Catholic hospitals agree to curtail procedures banned by Catholic hospitals. Or Catholic hospitals make sure that any banned procedure offered by the non-Catholic partner is provided in a venue geographically separate from the Catholic hospital and that the non-Catholic partner is not owned or financed by the Catholic hospital.

Ironically, the pro-choice movement is fiercely opposed to mergers of Catholic hospitals and non-Catholic hospitals. Pro-choice leaders say that Catholic doctrines prevail in such mergers and access to abortion, contraception and sterilization is reduced. In some cities, pro-choice groups have vigorously protested Catholic/non-Catholic mergers.

Ms. Magazine recently published a story on “Women’s Health: A Casualty of the Hospital Merger Mania,” and even mainstream USA Today editorialized on “Mergers’ Stealth War on Reproductive Rights.” Yet Catholic groups and leaders also question hospital mergers. The Catholic Health Association (CHA), which represents 1,200 Catholic heath-care systems and groups, forbids membership to for-profit hospitals. Sales or mergers of Catholic hospitals to for-profit systems are seen as problematic.

“The purpose of a publicly traded or investor-owned hospital is to provide a return on a shareholder’s investment,” says Father Michael Place, president and CEO of the CHA. “The purpose of a Catholic hospital is to engage in the healing ministry of Jesus Christ.” Studies show that investor-owned institutions reduce access to “unprofitable” care like burn and neonatal units and that nonprofit hospitals provide more community benefits than for-profit hospitals, says Place.

The late Cardinal Joseph L. Bernardin of Chicago, whose bout with cancer intensified his interest in health-care issues, often decried the commercialization of health care. Health care is not a commodity, but a basic human right, he said. Compared to a for-profit hospital, a not-for-profit hospital better promotes caring for costly and hard-to-serve populations, a patient-first ethic, attention to community-wide needs and volunteerism.

Rooted in religious faith, Catholic hospitals understand health care as a ministry of hope, said Bernardin. “Our distinctive vocation in Christian health care is not so much to heal better or more efficiently than anyone else,” he said. “It is to bring comfort to people by giving them an experience that will strengthen their confidence in life. The ultimate goal of our care is to give to those who are ill, through our care, a reason to hope.”

 

Jay Copp is the editor of the alumni magazine for De Paul University in Chicago, Illinois. The author of The Liguori Guide to Catholic U.S.A.: A Treasury of Churches, Schools, Monuments, Shrines, and Monasteries (Liguori, 1999), Copp lives with his wife and three young boys in La Grange Park, Illinois.

 


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