Spiritual and Religious Care

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Meet ‘Joyce’ – a wife, mother, grandmother and great-grandmother who lives in a pleasant home in a small Ontario community. With many friends and hobbies to keep her busy as well, Joyce’s life appeared to be going along pretty nicely. Then, in February 2003, she was diagnosed with non-Hodgkins lymphoma and her world changed in an instant.

She was admitted to William Osler Health Centre, a multi-site community hospital in the Greater Toronto Area, for chemotherapy and remained there for almost eleven months. The early days are still a blur. Most of the time she was on pain medication and at one time slipped into a semi-comatose state where she could hear what was going on around her but couldn’t open her eyes. She knew she was gravely ill though, and was aware that her family was devastated, facing the very real possibility that she could die.

“Still, I wasn’t afraid,” she recalls. “That’s strange, because I’m a worry wart…it’s very strange really.”

Where that confidence came from, Joyce can’t say. But it was justified. More than a year later, she sits in her living room, showing little of what she has been through except for the walker at her side, and talks of the prayers said on her behalf by her husband, family and friends. “I think the prayers made a big difference. These people believed I would get better and look at me now – I go outÉto the mall, the doctor’s officeÉI’m feeling pretty good. My doctor said to me, ‘Joyce, you’re a miracle!'”

Joyce isn’t alone in her conviction that prayer makes a difference. Everyday, in every corner of the world, pleas for healing are being sent out into the cosmos. They may be said collectively, in churches, temples and synagogues, or in solitary silence. In this electronic age, they are even said via the Internet. Yet they all have one thing in common – they come from the heart.

Scientists, never the most ethereal of people, have tried time and again to measure the value of prayer in the recovery process. Perhaps the best known example is a controversial study conducted at St. Luke’s Hospital in Kansas City, Missouri.

Researchers divided seriously ill cardiac patients into two groups. One group received daily prayers from Christian volunteers and the other group received no prayers. The participants were not told they were in a study, and the volunteers knew only the first names of the patients for whom they were praying.

Based on a list of possible outcomes, the researchers concluded that the group of patients receiving prayers fared about 11 per cent better than the control group, a significant number by medical research standards.

Other studies have also found a correlation between religious belief and reduced mortality, and there are numerous personal recovery stories told in the media and on web sites dedicated to spirituality and healing.

Part of the equation may be the strong support system that many people have within their religious community, the fact that a positive mental attitude can help boost the immune system, or possibly a placebo effect. Nevertheless, there appears to be a definite link between faith and health, so much so that that some medical professionals feel it should be a part of clinical care.

On the flip side of the debate are skeptics who argue that studies like the one at St. Luke’s contain a number of variables and are therefore unreliable. They view attempts to bring religion into the hospital room as one step away from quackery.

For the faithful, however, statistical evidence is beside the point. Faith, after all, is fundamentally unquantifiable. What matters is that the patient be treated as a whole person, not just a case.

Karen-Anne Fox and Garth Wittich are Chaplains at William Osler Health Centre. They are integrated into the hospital’s patient care program – attending rounds, meeting with members of the medical team to discuss individual patient concerns, and working with a multi-faith network of religious leaders to fill the spiritual needs of a diverse patient population.

In an environment where suffering is unavoidable and faith is put to the test on a daily basis, it’s not an easy job. The chaplains are a part of the emotional life of patients and families in times of joy when patients recover from serious illness, and in times of unspeakable sorrow.

Particularly after the death of a loved one, Fox finds many people tend to feel overwhelmed with self-blame about pain they may have caused and forget all that they did right during the person’s life. Bringing feelings of guilt and remorse into the open can help families deal with their grief. “If you can find peace, you can cope,” Fox says. “Sometimes you need someone to talk to in order to find it.”

For clinical staff though, discussing spiritual matters with patients can be a bit like threading a path through a minefield. Physicians especially are perceived to be in a position of power and have a lot of influence over their patients. Many are wary of providing what may be seen as false hope.At times, introducing prayer into the situation may even seem like a red flag to patients, an indication that the doctor no longer feels confident about the outcome.

Dr. Jeffrey Axler, a gastroenterologist, recalls one colleague who offered to pray with a patient and got an unexpected response. “The patient freaked out! That was not what he wanted to hear.” Axler says patients tend to expect a traditional model of medicine from doctors. So while he is supportive of their religious beliefs and willing to talk about religion, he doesn’t open the conversation.

Although raised in the Jewish faith, Axler is knowledgeable about Christianity and interested in the tenets of other religions as well. Not particularly devout as a young man, he has grown more interested in religion over the years and in the effect it has on his patients.

“It’s not unusual when someone is dying for them put up a cross or a picture of a patron saint,” he says. “It’s very interesting what people want to cling to at the end… they’re not putting up a picture of a building, or their car.”

At such times, in the midst of suffering and loss, God can seem like an absentee landlord, and there isn’t always an answer to the metaphysical question most often asked by patients, families and even hospital staff – ‘why’?

At those times, spiritual and religious care is less about providing reasons as it is about simply being there to offer a listening ear or share personal experiences. Wittich says, “Sometimes I tell patients about times in my own life when God seemed far away, but then I became aware of God’s presence in my life. It helps them to recognize something that may have already happened to them – perhaps just somebody who came along and said something or did something to help them that day – and they realize that was God working in their lives. It’s not always a direct message.”