When Elizabeth Edwards, wife of presidential candidate John Edwards, announced a few weeks ago that her cancer had recurred, this time in her bone, and that her disease could be managed but not cured, she focused national attention on what medicine can do-and what it can’t. We decided to do the same, asking 13 local chaplains, clergy and religious teachers recently the following questions: “What are the limits of medicine in the promotion of health and healing, and do faith communities have anything to contribute to the healing process?”
Virtually everyone interviewed preferred the terms “wholeness” or “wellness” to “health,” and certainly to “cure.” Sylvia Fromme, a chaplain at RUSH Oak Park Hospital (ROPH), said, “I prefer the word ‘wellness,’ because wellness implies a whole spectrum. There’s a balance of right relationships with self, others, the world and God. Wellness includes a physical component but is not limited by the state of my body. It’s much more holistic.”
Lois Klatt, professor emeritus of anatomy and physiology at Concordia University, agrees with Fromme. The Inter-Lutheran Coordinating Committee on Ministerial Health and Wellness, on which she served for 10 years, developed what they called a “Wellness Wheel” as a graphic metaphor for what wellness looks like. In the center of the wheel is written “In Baptism, a new creation in Christ” and all around the wheel are the components of wellness-physical, intellectual, social, emotional and vocational-and around these is another ring labeled spiritual well-being.
Klatt then moved from the academic model to a more folksy description.
“If, after one puts in a full day of work (however defined) and is able to enjoy some recreational activity and family,” she said, “and still has enough energy to handle an emergency situation and have a good night’s sleep, they are in good health.”
Marnie Rourke, a hospice chaplain, likes to distinguish between “curing” and “healing.” She said, “While it is true that hospice care has never cured a single person, it does bring healing to every patient, and to their families as well.”
Fromme told a story, about a patient who was dying of terminal cancer, that illustrated what Rourke was saying.
“When you went into her room,” said Fromme, “you got the feeling that she was caring for you.” This woman had her favorite donuts from Farmers’ Market and a vase of beautiful flowers. She made appointments with each person in her large family so they could say their last goodbyes to each other without distractions. “There was no morbidity about her death,” Fromme said. “She was one of the wellest people in the hospital.”
Aoife Lee, director of Spiritual Care at ROPH, considers health a relative term, specific to each individual.
“I would consider myself to be healthy,” she explained, “but at this moment I am a patient. Perhaps a word I would put in here is ‘balance’-balance in one’s life, a sense of well being. I can say I have a sense of well-being even though I may have a disorder or ailment.”
Heading toward health
There seemed to be a consensus among most religious professionals that perfect health or wellness, like true north, is an abstraction which no one ever reaches but can provide a sense of direction. Klatt views healing as a work in process, quoting Martin Luther who said, “This life, therefore, is not godliness but the process of becoming godly, not health, but getting well, not being but becoming. … We are not now what we shall be, but we are on the way.”
Sr. Sandi Sosnowski, a chaplain at West Suburban Hospital (WSH), puts it more simply. When asked if she would ever know perfect health, she smiled and replied, “Fifteen minutes after I die.”
The irony is that Sosnowski sees death as the door to ultimate healing, whereas for some in the medical profession it is the ultimate, inevitable defeat. In the case of Elizabeth Edwards, medicine is limited in its ability to cure, let alone heal. James Wind in “A Letter on Peace and Good Health,” coined the term “biomedicalism” to denote a narrow focus on drugs and medical technology as the only avenue to healing. Dr. Christina Puchalski at George Washington School of Medicine calls it “the disease/cure-oriented model of care.”
There’s a joke going around which makes the point in a different way. A doctor, upon finishing her exam, looks at her patient and says, “Your problem is that you are overmedicated. The good news is that, lucky for you, we have a pill for that.”
Increasingly, however, said Fromme, medical professionals are not only aware of the limits of medicine but are also open to other roads to healing. Most medical schools, she said, now offer courses in spirituality and health care. Once when she was finishing up a relaxation exercise with a patient, she noticed a physician waiting in the hall. When Fromme waved for her to come in, the doctor said, “I didn’t want to interrupt what you were doing.”
Likewise, Lee tells of a hospital CEO excusing himself from a patient’s room when she entered with the explanation that the chaplain’s visit with the person who was about to go into surgery was more important than his. On the one hand, said Lee, the future potential of medicine is almost limitless, with new, amazing discoveries being made all the time. On the other hand, she knows her role as chaplain in the healing of the patient is just as important as “the surgeon who removed the tumor.”
Jim Orders, another ROPH chaplain, said a family recently told him how much they appreciated a nurse who, every time he was not caring for other patients, would simply sit at the side of their loved one’s bed throughout his 12-hour shift.
Prayer’s influence
For millennia, religious people have believed that prayer in its many forms contributes to healing. Pastor Dave Frederick said, “At Vineyard we regularly pray for physical and emotional healing and see it happen.”
Beth Burbank, director of Clinical Pastoral Education and a Quaker, used the unique vocabulary of Friends when she said, “Many Friends believe in divine intervention. On the North Side of Chicago, we have a meeting for healing once a month in which we center down and hold friends in the light. Many people say they have been healed.”
Rabbi Victor Mirelman said members of his congregation recite prayers for healing in the daily Amidah, the main prayer that is said three times a day, and in special prayers as well. Judaism also emphasizes prophylaxis, he added, rituals like washing before eating, which are designed to prevent disease and maintain health.
Rev. Bob Irish, coordinator of Spiritual Services at West Sub, said the Sacrament of the Sick and the Sacrament of Reconciliation are the two main rituals Roman Catholics have for healing. Although many Catholics, he noted, still call it “the last rites,” the Sacrament of the Sick is used not just for the dying but for all cases of physical or emotional brokenness.
Healing takes many forms
And there is often relational pain connected with physical illness, he added, so family members may also be in great need of care, not just the patient. He uses the word “reconciliation” a great deal to describe the particular kind of healing patients and family members often need.
He recalled a young man who sat at his comatose father’s bed and kept repeating, “I love you, Dad.” For 15 years, the man had been plagued by regret that he had not come home when his mother was dying, and now, apparently, he had delayed coming to the hospital until his father was unable to respond to his guilt-ridden son. When Irish returned to the room after being called away briefly, he noticed a totally different mood in the room. There were hugs and crying but there was no longer a somber feeling.
“Chaplain, you missed it,” they all said. “Our brother was saying, ‘I love you,’ and just before he died, our father opened his eyes and smiled at his son, and then he died.”
“That,” said Rev. Irish, “was healing … for both the father and the son.”
Not every prayer is answered the way the praying person desires, religious professionals agree. Fromme spoke for many when she said, “I know there are miracles, but I don’t think they’re the rule of thumb. There’s mystery involved. I’m sure Jesus didn’t cure every sick person that he passed in his life.”
Sr. Sosnowski tried to explain the ambiguity this way: “‘No’ is an answer. I can remember my mother saying, “No” when as a child I asked her for something, and then she added, ‘That’s what happens when you pray. The answer will not always be what you want.’ I feel like praying, ‘Gracious God, you know what’s best for this patient. You know more than I will ever know. Take this patient where this patient is at and give them and their family what they need to get them through this moment.’
Christian Scientists agree that not every prayer is answered, but would say the reason is we aren’t praying correctly. They understand disease to be an illusion, and what prayer does is put one in contact with “Christ-healing.”
“As a Christian Scientist,” said Edwin Leever whose testimony is posted on the website, spirituality.com, “I’ve learned to promptly reject any harmful material condition as unreal because it doesn’t come from God, and to affirm my spiritual identity as the image and likeness of God. Over the years, I and my family have had many wonderful healings through this kind of prayer.”
In contrast, Robert Althouse who is a sensei at the Zen Community of Oak Park, said Zen Buddhism is a non-theistic religion, i.e. God does not figure in the picture at all. What he emphasizes is what Buddhists call awareness and mindfulness. “There seems to be clinical evidence,” he said, “that would support that there are some health benefits that can be derived from meditation, such as lowered blood pressure, less stress, etc.”
Science studies religious impact
There is, in fact, a growing number of empirical studies that indicate religious practices do have a positive effect on health and healing. Chaplain Lee declared, “For people who have heart issues, including transplants, there is hard data out there on the importance of spirituality and prayer in the healing process.”
Fromme agreed and mentioned a study by the Harvard Mind Body Institute which proved that conditions like diabetes, hypertension, cardiac arythmia, chronic pain, insomnia, anxiety, hostility, depression and the side effects of AIDS medications are ameliorated by the relaxation response.
Hard data? The Center for Spirituality, Theology and Health at Duke University listed 32 studies done by their center alone since 2004. Among them were “Religion and remission of depression in medical inpatients with heart failure/pulmonary disease,” which was published in 2007 in the Journal of Nervous and Mental Disease, and “Religion, spirituality and health in medically ill hospitalized older patients,” published in 2004 in the Journal of the American Geriatrics Association.
What about the scientific rigor of the studies? A synopsis of the 2007 study includes the following: “Of the 1,000 depressed patients identified at baseline, follow-up data on depression course was obtained on 87%. … Although numerous religious measures were unrelated by themselves to depression outcome, the combination of frequent religious attendance, prayer, Bible study and high intrinsic religiosity, predicted a 53 percent increase in speed of remission … after controls. Social support explained only 15 percent of this effect.”
Another study at the Duke center, however, was not complimentary of the methods of such researchers. After evaluating the methodology of 10 other studies on the connection between religion and healing, the center concluded that the evidence was persuasive in only one, had some persuasiveness in three, was inadequate in three and had consistent failures in three others.
George Fritchet, who himself does research at Rush Presbyterian on religion and healing, acknowledged, “There is a sharp debate on what the research shows on the relationship between religion and health.”
The Kaiser Family Foundation, meanwhile, reports that Americans spent $1.9 trillion on health care in 2004. That’s $6,280 per person in the U.S. and 16 percent of our Gross Domestic Product (GDP). Are we too enamored with biomedicalism as the only way to provide quality health care? Does our fascination with machines and chemicals on the one hand and our unwillingness to engage the disciplines of healthy living on the other, prevent us from attaining the very health we long for in a cost-effective way?
Molly Gaus, who does public relations at West Sub, observed that spiritual care comprises only a tiny percentage of even her Catholic hospital’s budget. While everyone interviewed, except for Christian Scientists, was impressed with the advances in and potential of medical science to heal, they also expressed conviction that their spiritual traditions were capable of making a powerful and low-cost contribution to our society’s quest for wellness.
