Sunday, September 19, 2010

The Healing Power of Prayer: Faith vs Reason?

Our society thrives on tension and competition.
  • GOP vs Democrats
  • Civil Libertarians vs Eavesdroppers
  • Ohio State vs Michigan
  • Creationists vs Darwinists
Ideas, like sports teams, compete to win. We are the referees of these contests. Many of these competitions in the public square are ongoing. Some of these duels are locked in a dead heat. Others are in overtime. Some are ‘challenge matches’ when a vanquished idea wants another shot to change the original outcome. Many of these controversies may never be resolved.

In addition, the outcomes may change because we – the referees – have changed. What was considered to be a foul years ago may now be regarded as fair play.

The medical profession is riddled with many internal conflicts that will not be easily resolved. Here are a few, and I’m sure readers could add generously to the list. 
  • Primary Care vs Medical Specialists
  • Physicians vs Insurance Companies
  • Obstetricians vs Medical Malpractice Attorneys
  • Fee-for-Service vs Salaried Medicine
  • Evidence-Based Medicine vs Alternative Medicine
A patient I saw some months ago in the hospital illustrated another conflict that we physicians face, from time to time. Although the case was a typical case of internal bleeding, it could be classified as a Case of Faith vs Reason. Here’s a brief synopsis of the case.

An 81-year-old male was hospitalized with rectal bleeding. I had treated this man years ago, and was requested to assist in his care once again. Gastroenterologists are typically consulted on patients with internal bleeding. A day later, I performed a colonoscopy and determined that the bleeding was originating from pouches in the large intestine called diverticula. This is a common scenario and the bleeding usually ceases spontaneously. Each day, he continued to bleed, but never to an alarming degree. He received only 2 units (pints) of blood over the first few days, indicating that he was not in urgent danger. Then, he had an abrupt event when he bled suddenly and dropped his blood pressure. At that point, he was transferred to the intensive care unit for closer observation. He was given additional blood transfusions and a 2nd bleeding event occurred. We performed an urgent angiogram, which is useful in acute, ongoing bleeding to identify the leaking artery and to seal it. The result was completely negative.

Most physicians at this point would advise the patient to consider surgery, to remove the section of the large intestine that is continuing to bleed. I requested that surgeon evaluate the patient and anticipated that he would perform surgery on that very day. My assumption was incorrect. The surgeon, a careful and compassionate physician, agreed that surgery was indicated, but no operation would take place. The patient preferred a different therapeutic plan, which I will paraphrase here.
“I think I’m just going to pray. If I’m still bleeding after the weekend, then we can talk again.”
This is a man who knows something about faith. He has been a priest for longer than I have been alive. He also knows about reason. He has more post-graduate formal education than nearly anyone I know. After earning his baccalaureate undergraduate degree, he earned a masters and doctoral degree. But for a dissertation, he would have earned a second Ph.D.

I would have opted for the surgery for myself, and would have enthusiastically supported his decision to undergo it. But, I wasn’t the referee in this contest, he was. He listened carefully to the medical professionals, and then viewed this information through the prism of his own life experiences and beliefs. I’m sure there was a contest occurring in his own mind, but he was able resolve it calmly and confidently. He didn’t say that he wouldn’t have surgery, only that he wanted to try something else first.

The bleeding stopped and the patient was discharged. The surgeon remained idle. Did the patient know something that the rest of us trained physicians didn’t? Clearly, he knows that choosing the best answer on the gastro board exam may not be the right answer for him. It’s refreshing to watch someone who can choose a different direction defying convention and momentum. Again, this man is not an idealogue. He was willing to call the surgeon back.

I was so honored when he presented me with an inscribed copy of his autobiography entitled, I Looked Up and Heard God Calling Me. At the end of the book, Father Pittman writes:
Even now as I look back, I believe that I reached a stage of prayer that I have not yet equaled in fifty years of training and practice as a religious. I can still see the goodness of the Lord in all that happened.  
I am honored to care for many priests and nuns in my practice. They are wonderful human beings who exude peace and contentment. They tell me that they pray for me, and I’m glad that they do. Who would turn down prayers from Father Pittman?


What do readers think?


12 comments:

Elaine Schattner, M.D. said...

Wonderful post! Among other takes - sometimes things happen that even the most educated of people don't expect or understand.

The Medical Contrarian said...

I have no desire to comment on causality. It is not a tested hypothesis, although it is testable. This scenario is not unlike so many other circumstances within medical practice. We physicians assume we know what the odds are of any given future event. In this case, we have an elderly man who had a GI bleeding episode which apparently does not want to resolve.

However, what are the odds that it will resolve on its own and how could be know? In order to know that data, you would need to have a population of Father Pittman's presenting under similar circumstances and followed for a requisite period of time with the outcomes collected, stored, and analyzed.
That has never happened. Absent that data, we rely on our recollection of similar events which unfortunately is riddled with all types of recall bias.

I lesson from the good Dr. Kirsch is a valuable one. Yes the patient should have the final word. What decisions may on the surface appear to be irrational may in fact be no more irrational than our recommendations. Trusting in a higher power, whether real or not, has its merits and may contain as much or more truth than what we base our experts opinions upon.

One final caveat. There are times where our medical recommendations are really based upon hard data. We need to know when these are and when the stakes warrant making a strong stand.

Chrysalis said...

What an interesting post. It was nice to read this, Michael.

"Did the patient know something that the rest of us trained physicians didn’t?" I do believe there is a knowing in some of us. We can know both that we are in serious trouble, and that there may be healing without man's intervention.

Nicholas Fogelson, MD said...

Great story! I take it not as any particular lesson, just that often the body can heal itself if we give it a chance.

I also have a belief that there is something about us as humans that exists beyond the purely physical form. Some call that a soul, some call it God. I prefer to think that it is a entity that will one day be described by a level of science yet to be discovered, most likely describing the existence of matter or energy in dimensions beyond those we routinely experience.

Did Father Pittman influence his outcome through his prayer? Perhaps so. Some would call that the intervention of god. I would say that he may have tapped into that part of existence that we have yet to define. I think as we further discover the nature of existence, we will find that these are not such different things.

zalfi said...

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thanks GBU

A. Bailey said...

I have to say that I'm a bit disappointed in all of this.

When I saw the subject and after reading a few lines, I expected you to be mobbed by angry atheists condemning the surgeon's actions as tantamount to witchcraft and malpractice.

At which time I would have quoted one my favorite lines from Hamlet: "There are more things in heaven and earth, Horatio,
Than are dreamt of in your philosophy."

Which is to say that the biosociopsychological model of medicine doesn't always account for everything that happens in this old world.

Well done, sir.

SeaSpray said...

Hi Dr Whistleblower - this is my first visit here and I've been reading through posts and comments. Terrific blog posts and comments!

What do you prefer to be called when addressed in comments?

I LOVE your Healing Power of Prayer post and identify with it greatly. I have been tring to stave off a high risk ureteral reconstruction surgery that now seems imminent. I am told I have to have it and I have stalled (because I do believe in miracles, etc), but it seems this is just the path I have to take.

But ..your patient just asked for the weekend to pray. I now find myself hoping for an 11th hr and 59 second rescue ..even if it means they open me up and see a new ureter.

I know that sounds crazy to most ..but I really do believe God can do anything he chooses. I don't pretend to understand his reasoning for why things do or don't happen as they do ...but I do know he can intervene. But ...I also know he usually works through physicians, other med professionals and medicine.

Still ..I can't help hoping. I have been discouraged ..but thankfully ..hope swells up in me again.

Anyway ...I'm going to link this post to my SeaSpray blog, a couple of paragraphs and part of a comment that really spoke to me. I hope that is alright. I will definitely direct readers over here. And at some point I'd like to link it in our Positive Medical Blog.

I'm also blogrolling you. :)

Great post!

Michael Kirsch, M.D. said...

@SeaSpray, welcome to the blog and thanks for the kind comments. As far as how to address me, I've been called many things, and defer the issue to your judgment. Great ocean photo on your blog!

SeaSpray said...

Your welcome ...

Dr Kirsh?
Dr MD?
Dr Whistleblower?
MD Whistleblower?
Whistleblower?
DrWB?
Mike?

And thank you for the great posts and thank you for letting me use excerpts and linking to your blog.

Um ..at sometime in the future a post will be going up in ss on why I'd never work for a gastroenterolgist, but it is meant to be humorous with an element of truth. It's simple really. :)

Thank God for your profession - you save lives, etc. :)

The Healing Power of Prayer said...

Dr. Kirsch,
Thank you for your post about Father Robert Pittman. I have known him for almost 20 years and he is a true believer in the power of prayer and quite a remarkable survivor. It is a privilege to be his caregiver and friend. He is grateful for your care and friendship over the years as well and will be in town soon.
He has told me he is also thankful that you and his surgeon gave him a bit of time to pray about his situation before being operated on. Prayer worked this time...but we still need the fine physicians like you to be there as guardian angels when needed!
Sincerely,
Chris Detzel, RN.
Congregation of the Blessed Sacrament

Healing Power of Prayer... said...

May God bless you Dr. Kirsch! I love you as a kind and loving friend as well as my doctor. I thank you for proclaiming the Good News of how I got cured. I had recently been reflecting on fanty prayer, how to use imagination to make Jesus present. As I was being prepared to go the the operation room I imagined Jesus was sitting in front of me. I said to him you healed the woman you touched your cloak heal me and reached out and touched his cloak immediately I felt better. Then the Eucharistic minister came with the Blessed Sacrament although my nure felt maybe I should not take it on the way to the operating room I took it anyway. When I got on the operating table they could not find any bleeding I was cured. I proclaim the Good News and thank God and all who worked under him to help me. MAY WE ALL PRAISE AND THANK GOD ALWAYS!
Robert S. Pittman
Congregation of the Blessed Sacrament

Anonymous said...

We believe in the power of prayer and we're so thankful for the healing mercy God has bestowed on Fr. Pittman! Our Heavenly Father has truly blessed our family and parish with Fr. Pittman. He is a true testament of God's grace and presence to all he serves and ministers to. We are moving cross country and will dearly miss Fr. Pittman! We'll always remember his first words to the parish congregation each time he celebrates Mass - "I love you!" (with outstretched arms). Our prayers will be with him as he continues his journey towards Heaven while inspiring others to join him. May his wonderful ministries continue to help those in need. Thank you Dr. Kirsch for posting his story

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