ROCHESTER, MINN. — The press that followed a recent visit by the Dalai Lama to the Mayo Clinic focused primarily on the spiritual leader's comments about the Chinese crackdown on protest in Tibet. It isn't hard to imagine why. The meeting's contentious international backdrop — a conflict underscored by the sidewalk appearance of a strangely polished crew of 50 or so pro-Chinese demonstrators mounting a lonely crusade to tarnish the cause of Tibetan autonomy — was an easier tale to tell than the less easily digested topic of the daylong event itself.
The oversight was unfortunate, because the case being made during the April 16 colloquium titled "Investigating the Mind-Body Connection: The Science and Clinical Applications of Meditation," seems far more destabilizing than the political movement in Tibet.
It's one thing to ponder the irony of a professional-seeming protest in defense of a government that does not allow protest. It's quite another thing to witness the brain trust behind the brand more associated with Western medicine than any other giving forum to the emerging science of mindfulness training, acceptance, positive thinking and compassion. The first cause is about political change. The second is cosmological.
The Buddhist meditative tradition
The Dalai Lama's prescription is that of the Buddhist meditative tradition: selecting and focusing on positive mental states such as compassion, gratitude and joy, while challenging negative mental states such as anger, jealousy, anxiety and a distracted state of being. In practice this means daily meditative practice intent on clearing mental clutter and developing more clarity of attention and moment-by-moment awareness.
The Dalai Lama has long believed that so-called mindfulness meditation has beneficial effects on human health and well-being, and thanks to research conducted by Davidson and others, we now know that the brain and body do indeed change for the better as a result of such practice, and through measurable physiological pathways more complex than had previously been imagined.
Researchers have known for years, for example, that a bilateral brain region known as the prefrontal cortex, or PFC, is involved in developing responses to emotionally laden thoughts, and that the way we respond to the events and thoughts in our lives is often determined by whether the brain draws on the rights side of our PFC or its left. Operating below the level of awareness, the right side of the prefrontal cortex responds to problems with an eye toward punishments and avenues of withdrawal, while the left side processes thoughts which are generally positive and tuned to rewards. Damage the left prefrontal cortex and depression increases; those who tend to preferentially use the left side of their prefrontal cortex tend to get over problems faster than do those who process emotion-laden thoughts from the right. Significant for the discussion of physical health, those who preferentially use the left prefrontal cortex show lower baseline levels of the stress hormone cortisol.
The dangers of chronic frustration
A separate area of research has linked chronic frustration with disruption of your heart-rate variability, which, sustained over time, the body begins to recognize as its baseline state, bringing about an inhibition of the vital bodily calming mechanism that is your parasympathetic nervous system. Feel frustrated long enough and your body ceases to calm itself.
By wiring EEG sensors to the heads of Buddhist monks and those attempting to meditate for the first time, then examining brain activity as expressed on functional MRI images, Davidson and Kabat-Zinn have learned that meditation employs the left prefrontal cortex — some monks he has studied have greater left prefrontal orientation than ever previously observed — and that over time, meditative practice can change the orientation from the right to the left of those who take up the activity. Brain circuitry is not fixed, in other words. To the contrary, said Davidson during a research-based session at Mayo, "the brain is the organ that is built to change in response to training. Happiness, compassion, and clarity of attention are the product of skills, and these skills can be enhanced through mental training."
After hearing the case that meditative mental training can help people stay healthier and recover more quickly from illness, the Mayo audience of 350 or so faculty and staff entered more culturally problematic territory — subject matter that seemed to be talked around as much as it was examined. In short, while medicine is beginning to take seriously the notion that the cultivation of compassion and mindfulness is beneficial for physical health, medicine as practiced today is often antithetical to the very mindfulness and spiritual "present-ness" sought after in meditative practice.
An East-West paradox?
The clinic may have established a "mind-body" Department of Integrative Medicine and gathered with earnest enthusiasm to hear from the top names in mind-body research, but Mayo is nothing if not the face of Western medicine in all its dichotomous cleaving of the spirit from the biology, both in culture and practice. The medical embrace of meditative compassion would seem to face a paradox: The grueling rise to the highest levels of medical specialization does not appear conducive to regular breaks for contemplative meditative practice, nor does the culture of omnipotence, authority and spirit of conquest within medical training seem a smooth fit for the sense of acceptance embodied in Buddhism.
The bad news came in large part from Roshi Joan Halifax, a Zen priest and medical anthropologist whose remarks suggested that embracing the Buddhist prescription will likely require more than stocking the patient information center with brochures on the value of meditation. For example, the Dalai Lama's thoughts on death are clear: "I think the most important thing," according to a Web collection of his sayings, "is to try and do our best to ensure that dying person may depart quietly, with serenity and in a peace." Caregivers of those at the end of life experience high rates of burnout, said Halifax, due to the "moral stress" brought on by the damage done to this peace by conflicting agendas of medicine in the face of death.
"A lot of clinicians feel reluctant to speak openly about the trajectory of an illness," she said, "with death being the end of the road." Halifax described the multipronged source of the physician's moral stress that leads him or her to avoid the dying: interventions which cause pain and suffering, lack of communication about the goals of care, and "the prolonging of dying through technology." While she acknowledged their role in transitory illness, flashing a picture of an iconic string of ICU life preserving tubes and machinery, she said simply, "This is our nightmare, to be put on a respirator."
Cultivating compassion, wisdom in the face of death
Halifax advocated helping physicians and caregivers in "cultivating compassion and wisdom in the presence of death." The ability to "presence pain and suffering without pitying, consoling or denying," said Halifax, requires "a quality of attention that is panoramic, perceptive and nonjudgmental." While meditative practice would seem to develop the skill in question, hanging over her argument was a question that went unasked: How likely are these skills to be developed in medical training, much less the culture and bureaucracy of large medical centers like Mayo? Research may support the benefits of meditative practice for patients, but if they are to care for the dying and gravely ill, physicians would appear to need an extra dose the same medicine. Is the Buddhist tradition even possible within the umbrella of Western medicine?
"Allow yourself to experience that futility," she said when a Mayo doctor from Brazil asked how he should handle his negative emotions that gave rise when watching patients in his homeland die unnecessarily due to a lack of resources. "To be with things as they are. There is still a resource that is there — your presence."
For the Mayo brothers, looking down from nearby oversize vintage photos upon the gathering, this could not have seemed a stranger request for the heirs to their legacy. Nor could the answer given to a similar question a few minutes later — and which had been put to Mattieu Ricard, a French-born monk from Katmandu and a subject of Davidson's EEG experiments on the brain activity of expert level meditation.
"Transform your attitude to the suffering person," said Ricard, who has spent more than 10,000 hours in contemplative meditation. "Let your heart become a mass of brilliant white light, and the suffering becomes dissolved in it."
The nature of compassion and suffering
After a lunch-hour break, the audience stood silently to greet the Dalai Lama, a sometimes impish figure who held forth bare-armed and robed from an armchair in the center of the stage. Answering questions put to him by Goleman and later the audience, the Dalai Lama alternated from English to long statements toward his interpreter, presumably in Tibetic, touching on the nature of compassion and suffering and its intersection with medical care. He rambled at times in a way that indicated no worries about social pressures like staying on message, making easily digestible bullet points, winning over his audience — and yet winning over his audience regardless.
He explained his position that the human dilemma is one whereby anger and attachment — while useful if a transitory emotion in species throughout the animal kingdom — are given undue extension by the human skill for imagination, with negative results.
"This is where the problems arise," he said. "Because of this, we need a special effort to increase our affection."
He called compassion "an immune system for the toxins of the mind." He also, early in his remarks, slipped in mention of the problem at hand, a statement that sparked no shortage of nervous laughter in the highly credentialed crowd.
"In Tibet we have a saying," he said. "The physician is a great scholar, but his medicine is not effective because his heart is not that good."
Paul Scott is a freelance writer based in Rochester.
Dalai Lama: Lessons of Buddhism as applied to medicine
By JOSEPHINE MARCOTTY, Star Tribune
Last update: April 16, 2008
(Page 1 of 2. Click on external link for complete article)
He admits his mind is scattered by the events of the last month and he's worried. But despite the Dalai Lama's troubled feelings about turmoil between his native Tibet and China, he is sleeping well.
Abiding by Buddhism's teachings has helped him maintain peace and compassion in the face of life's trials, the Dalai Lama told 400 doctors and nurses Wednesday at the Mayo Clinic in Rochester.
"If there is no solution, why worry?" he replied when asked how he maintains his good cheer and optimism in the midst of life's trials. "If there is a solution, why worry?"
The Dalai Lama was in Rochester for his annual check-up at the Mayo Clinic. But in the afternoon, he spoke with the clinic's doctors and nurses about compassion, and his concern that health care workers can be emotionally exhausted by dealing with the pain of others day after day.
The crowd stood in respectful silence as he entered a conference room at the world-renowned clinic and made his way to the stage. He and a group of monks stood out in their brilliant red and yellow robes, like birds of paradise amidst a Minnesota crowd wearing dark suits and sensible pants. In a nearby hotel, 300 Tibetans gathered to watch by video link.
The crowd at the clinic listened intently as he began a philosophical discussion about compassion and trust, and how to apply the lessons of Buddhism to modern western medicine.
To many in the room, he represented two worlds. The Dalai Lama is believed by Tibetans to be a manifestation of the Buddha of Compassion, who chose to be reincarnated to serve human beings. In that role, he is a spokesman for the compassionate and peaceful resolution of human conflict.
But he is also a great student of science and has supported western researchers studying the power of the mind in relation to illness and healing.
"This is part of the future of medicine," said Dr. Doris Taylor, a stem cell researcher specializing in cardiac medicine at the University of Minnesota. "We are beginning to have a scientific understanding of this. I couldn't not be here."
"We see so many patients that we can only get to a certain point in healing," said Dr. Tim Johnson, director of Mayo's Austin clinic. "That mind-body spiritual connection is often something that is missing in our patients and ourselves. But it's important in their health and well-being."
Tough compassion
"What do you see as the role of compassion in medicine?" asked Daniel Goleman, a psychologist who writes about the brain and emotion, and who led the discussion.
The Dalai Lama scratched his nose for a minute while pondering the question.
"One time in Japan, a doctor asked me about trust between patients and doctors," he said. "Trust is very important. Then he asked me how to develop trust. I don't know. But the key thing is the doctor's sense of concern. His sense of commitment, his sense of responsibility with affection. Genuine affection for the patient. That is the basis of trust." Trust, he noted, needs to be mixed with compassion.
But he also urged what Goleman said might best be described by the phrase "tough love." Compassion, the Dalai Lama said, doesn't mean pity or pure empathy. Sometimes, nurses just have to be stern with difficult patients, he added.
Goleman asked how Buddhist practices could reduce emotional stress for health care workers.
"Joy," replied the Dalai Lama -- joy in the pursuit of work is very important, particularly in health care. "You are directly involved in relieving the suffering of the person in front of you," he said. "Recognizing the value of that will sustain your joy in your work."
But equally important, he said, is that each of us aspire to our own happiness, that on a fundamental level we care for ourselves.
Though a belief in the power of prayer is central to many Christian denominations and other faiths, the healing it offers might have a greater effect on spiritual wounds than physical ailments.
Eleven-year-old Kara Neumann died March 23 of complications from untreated diabetes after her parents chose to pray for recovery at their town of Weston home rather than seek medical treatment.
Mike Neill, a chaplain at Aspirus Wausau Hospital, said he'd never personally encountered a family who chose prayer as a treatment over medical care.
Neill said he believes in prayer's power, noting it has benefits "even at times when we don't see healing" quickly or in the ways we seek. For many people, however, it can help them come to terms with what's happened and give them comfort. It also enables them to turn over what they can't control to God and helps them know God is with them.
"We are holistic beings," Neill said, and a person's emotional, physical and spiritual make-up are intertwined.
Research suggests many people pray and use other spiritual practices for healing. Forty-five percent of 31,000 people surveyed in 2004 used prayer for health reasons, according to research conducted by the National Center for Health Statistics and the National Center for Complimentary and Alternative Medicine. Almost one quarter reported having others pray for them.
"There is already some preliminary evidence for a connection between prayer and related practices and health outcomes. For example, we've seen some evidence that religious affiliation and religious practices are associated with health and mortality -- in other words, with better health and longer life," wrote Catherine Stoney, program officer at the National Center for Complimentary and Alternative Medicine.
Still, researchers cannot determine cause and effect.
Studies suggest prayer seeking intervention -- called intercessory prayer -- has no effect as a treatment, said Dr. Steven Miles, professor at the University of Minnesota's Center for Bioethics.
A study of almost 800 people published in 2001 by Mayo Clinic researchers found patients with heart conditions who were prayed for fared no better than those who were not. A 2006 study by Harvard Medical School researchers of about 1,200 heart bypass surgery patients found those who were prayed for had similar rates of complications within a month of their operations to those for whom no prayers were offered.
Surgeon writes about the spiritual side of medicine
Professor Q & A
By: Aly Van Dyke
Allan J. Hamilton is a professor of surgery at the UA. He graduated with honors from Harvard Medical School and finished his neurosurgical residency at Massachusetts General Hospital. Hamilton has worked at the UA for 18 years.
Hamilton recently published "The Scalpel and the Soul." In the book, Hamilton delves into the correlation between the physical and spiritual aspects of surgery by recounting his experiences with spirituality in and out of the operating room.
Hamilton began working on the book in 2004, and it was released March 13. The book is available in the UofA Bookstore for $23.95. He sat down with the Arizona Daily Wildcat yesterday before his book signing in the UofA Bookstore to talk about the book.
Hamilton: Mostly patients who are facing severe illness or major surgery. The second group is probably people in the health care profession who are taking care of these patients.
W: What were you trying to accomplish?
H: I was hoping to pass on some lessons I learned from patients about harnessing their own emotional and spiritual energies to enhance their recovery.
W: What is one experience you talk about in your book?
H: I had a young man who had a brain tumor, a malignant cancer, and I operated on him and took care of him. His big hobby was fishing. He went through the regular regimen of chemo and radiation. He came to me one day and said, "I know I'm going to beat this thing, but if things really get bad, I want you to promise me you'll tell me when it's time to go fishing." And it went on for several years and unfortunately the tumor grew back and he had multiple operations, but the tumor was invading his brain and his spinal cord. One day I took him aside, and I asked him if he remembered when we talked about when it was time to go fishing, and I told him it was time. And the next morning his family called me and told me he was dead. And I think I snipped that cord of hope he had. I think when he saw me give up, he gave up. It just taught me that no one has the right to take away somebody else's hope.
W: In your book, you list some "Rules to live by." Could you tell us some?
H: I'll mention a couple of my favorites. One of my favorites is, "Don't let yourself be turned into a patient." A hospital has a way of removing your identity ... I really think that's a bad idea. I think you want to assert your identity. So bring your favorite T-shirt and wear your crazy sweat pants. Instead of those little paper slippers they give you, go get the big, fluffy, bunny slippers that you love. You aren't a disease in that bed. You are a patient in the bed with a disease. Music has a lot to play, I always tell patients to make their own soundtrack for their recovery. I tell them to put together some music that will convey some of the emotions that they want.
W: Do you think, as a surgeon, you lose any credibility in talking about spirituality?
H: I don't think it's credibility that you lose. Surgeons are a very, very conservative group. We are masters of technique. We are as mechanistic a field as there is. So I think that field of colleagues asks if we should really even be talking about this. And yet you have a lot of them that come up to you and say, "I've seen things I couldn't explain and I didn't dare tell anybody." I think there are a lot of people that are just afraid to discuss it. Nobody talked to me about this. You go right into this with your patients, and you don't realize that their spiritual challenges are going to have an effect on you too.
W: Do you think medical schools will start addressing the spiritual issues of surgery?
H: They are. I think patients are really insisting on it, and I think the younger generation is responsive to it. Fifteen years ago we had less than 10 percent of medical schools even having anything related to spirituality in medicine. Now it's nearly 70 percent.
Early in Dr. Allan Hamilton's career, a young boy who had spent months in a coma after suffering severe burns claimed to see his recently dead father standing at his bed.
Hamilton told the boy, named Thomas, that his father had died. The boy's reaction was to wave to his father and tell the doctor that it must be his father's spirit watching over him.
Hamilton, a surgeon for 25 years, 18 with the University of Arizona Health Sciences Center, was not religious or spiritual at the time of Thomas' surgery and rejected those things that could not be explained by medical science. Thomas' faith was the start of the doctor's journey into the spiritual and supernatural.
Hamilton's experiences into the unknown while becoming a successful brain surgeon and now a surgical consultant for the TV show "Grey's Anatomy," are chronicled in his new book, "The Scalpel and the Soul: Encounters with Surgery, the Supernatural and the Healing Power of Hope."
He said the book is his personal spiritual evolution, which happened because of his patients. Those experiences include an American Indian shaman telling him to let a patient die and a woman who was brain dead during surgery but remembered conversations between the doctors and nurses.
Since his book's release, Hamilton said he's gotten three reactions. Some people have told him that surgeons shouldn't discuss spirituality. Others have been grateful that someone is finally brave enough to talk about spirituality and medicine.
The third group, he said, is medical residents and interns who tell him they are relieved to learn that there can be more to medicine than just the science.
Hamilton didn't see Thomas for another eight years as he continued his residency at Massachusetts General Hospital. As he prepared to leave on his last day, he encountered a woman and a teenage boy who had obviously been a burn victim. At that moment he realized it was Thomas.
He wrote in his book: "As I saw Thomas smile and wave, I reminded myself I had been permitted to watch the mortal threads of my life, interweave with the strands of the spiritual powers in Thomas' life. . . . This eight year-long adventure was not just the story of a surgical residency. It was a message: We're never solitary mortal beings."
Bypassing 'Big Pharma' with Alternative Medical Treatment
Holistic, non-toxic therapies gain ground in wake of drug recalls
March 14, 2008 --
Pamela Hoeppner, author of The Breast Stays Put ($15.99, paperback, 978-1-60477-103-9), is living proof that alternative treatments can not only keep you healthy but win the battle against cancer. She, along with two other new authors from Xulon Press, is spreading the word that people must take charge of their own healthcare and now have choices other than conventional medicine. In the wake of the healthcare crisis and repeated drug recalls, Americans are discovering the body's miraculous ability to heal itself through non-toxic and alternative therapies, or what one physician has called "the medicine of the 21st century."
After running her own successful business in Wellness Alternatives, Hoeppner faced the unthinkable. She was diagnosed with a malignant, fast-growing breast cancer. She declined all conventional treatment and chose an alternative approach with an impressive track record-- Protocel®. In her inspiring book, she shares her courageous story of overcoming a deadly diagnosis and provides prevention and treatment information. "With the Internet, and the world of alternative medicine it opens up only a click away, people today are taking charge of their lives, especially their health, and they're searching for options. The Breast Stays Put was my way of telling the world, 'You do have options--I found my answer--and I'm living proof that bona fide options and choices exist!'"
Author Ricki Pepin's son suffered for more than a decade with an unexplained, disabling illness. Desperate for answers, Pepin embarked on an intensive search for answers amid confusing and often conflicting medical data. She discovered seven biblical principles that she believes is God's prescription for healthy living. God's Health Plan: The Audacious Journey to a Better Life ($17.99, paperback, 978-1-60266-698-6; $27.99, hardcover, 978-1-60266-699-3), is based on her effort to find help for her child. "It's about wholeness and restoration of mind, body and spirit," says Pepin. "It's about adding life to your years, not just years to your life."
The seven principles encompass food choices, medical care alternatives, and environmental stewardship practices that will create healthier lives and a replenished world. Pepin believes we stand on the brink of a medical paradigm shift from fighting disease to maintaining health, but individuals face enormous frustration as they begin to take charge of maintaining their own health. "There is so much information available in the health industry today, and it is often hard to decipher what is true and what is mere hype," Pepin says. "This book will help ordinary people to sift out the fads and fallacies and find God's principles on health, which can lead to their own physical and spiritual restoration."
In the midst of confusing modern-day diets, food restrictions, and unnecessary fear-inducing food warnings, What the Best Doctor Recommends (paperback, 978-1-60477-552-5) reaches out to the many disillusioned souls who struggle with unnecessary food-related battles. Written by "Ms. Abigail" (penname), the book presents time-tested biblical secrets to eating--secrets which have been programmed within us since creation. It offers a simple, realistic, and logical solution for today's broad spectrum of dieting debates and health issues. Those principles helped the author completely overcome all her food-related issues on a physical, mental, and emotional level. "My mission is to spread a message of hope, one that lifts the confusion and relieves the frustration that countless diets and food restrictions have created in the lives of many," says Ms. Abigail.
Xulon Press, a part of Salem Communications Corporation, is the world's largest Christian publisher, with more than 5,000 titles published to date. Retailers may order the books mentioned above through Ingram Book Company and/or Spring Arbor Book Distributors.
Some medical schools require students to take at least one course examining the role faith plays.
By Bonnie Booth, AMNews correspondent.
March 4, 2008.
Christina M. Puchalski, MD, was a bit of a pioneer when she created a spirituality and health course in 1992 at George Washington University School of Medicine in Washington, D.C.
The course, offered as an elective, covered spiritual practices, including meditation, as well as topics such as humor and alternative medicine.
When Dr. Puchalski first began teaching her course, 2% of medical schools offered course work in spirituality. By 2004, the figure was 67%.
Now 100 of the approximately 150 U.S. medical schools offer some variation of spirituality-in-medicine course work. And 75 of those 100 require their students to take at least one course on the topic.
Dr. Puchalski can take some credit for the change. She and a colleague developed a program in spirituality and health at the National Institute for Healthcare Research. Funding by the John Templeton Foundation -- an organization that makes grants to research projects -- has given medical schools the opportunity to develop a spirituality curriculum of their own.
100 U.S. medical schools offer some kind of spirituality course. Dr. Puchalski has worked with the Assn. of American Medical Colleges to define spirituality as part of the Medical School Objectives Project.
According to the MSOP, "spirituality is recognized as a factor that contributes to health in many persons. It is expressed in an individual's search for ultimate meaning through participation in religion, and/or belief in God, family, naturalism, humanism and the arts. All of these factors can influence how patients and health care professionals perceive health and illness and how they interact with one another."
76% of doctors believe in God, and 59% believe in an afterlife.
In recent years, more research has examined the links between faith and physicians. In 2005, a nationwide study found that 76% of physicians believed in God, and 59% believed in an afterlife. Physicians are more likely to attend religious services than the rest of U.S. population, said the study in the July 2005 Journal of General Internal Medicine.
Some experts said doctors don't know if it's appropriate to incorporate faith into medical practice. Doctors also might be unsure if they should address the topic of their patients' beliefs.
Research aside, social trends have led medical schools to consider spirituality in their curriculum planning, Dr. Puchalski said.
She said that during the mid-20th century, medicine shifted away from the physician-patient relationship and holistic care to a disease-centered model that focused more on advances in science and technology.
The switch to managed care, the diminishing doctor-patient relationship and public pressure brought demands for change. The increased criticism of the medical system as a whole, she said, also stimulated changes in medical education.
The goal today, Dr. Puchalski said, is to help medical students understand how they can be compassionate participants in their patients' lives.
Dr. Bruce Leibert makes no apologies for who he is: a devout, outspoken, Christian doctor who asks to pray with patients and asks them about their spiritual beliefs.
Leibert, program director of Valley Baptist Family Residency in Harlingen, openly incorporates spirituality into his practice because he believes it makes a difference in patients’ physical and mental health.
“Health must address not only body, not only the mind, but the undying soul. … If I can’t minister to the soul, then I can’t do medicine.”
In the past, a clear boundary has existed between religion and medicine: chaplains and pastors visited hospitals to tend to patients’ spiritual needs, while doctors and other healthcare providers were expected to solely treat the physical.
But that line between faith and science is starting to blur, as more healthcare providers and hospitals incorporate spirituality into patient care.
From Bible studies for healthcare workers to prayer time with patients and meditation classes at hospitals, faith is playing a more prominent role in the healthcare setting — and for a good reason, experts say.
“Science is telling us clearly that when you activate your spirituality, various things happen in the body that help you heal better in times of disease and distress,” said Dr. R. Murali Krishna, president of the James L. Hall Center for Mind, Body and Spirit in Oklahoma City. Krishna and others founded the center 10 years ago, hoping to increase patient awareness about the mind-body connection, he said.
The center offers seminars on meditation, guided imagery and relaxation, in part to help people achieve that connection, he said.
“It helps you access the healing power within yourself,” Krishna said.
Connecting mind, body and spirit
Researchers have actively studied the mind-body connection since the 1960s, according to the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health.
Studies have suggested that mind-calming practices like meditation, yoga and visualization can help reduce chronic pain, improve immunity, speed wound healing and reduce stress, which in turn improves health.
More researchers are now looking into whether similar results come from prayer, church attendance or strong belief in a religion. Some studies have indicated that spiritual beliefs and practices can improve the mental and physical health of the chronically ill and the sick elderly, improve patients’ ability to cope with pain and distress and protect against depression.
Patients seem to want to talk about spirituality and faith with their doctors, according to a 2004 survey that appeared in the Annals of Family Medicine. The survey found that 83 percent of respondents wanted their doctors to ask about their spiritual beliefs, and a majority wanted those beliefs to be considered when planning treatment.
Some local doctors routinely take a “spiritual history” of their patients. Leibert, for example, often asks questions like “Do you go to church regularly?” and “Do you pray?”
A spiritual history can help doctors tailor treatment to the individual patient, said Dr. Linda Villarreal, an Edinburg internist.
If a patient is suffering from symptoms related to stress, for example, she’ll suggest prayer or meditation depending on what the patient believes, she said.
Faith is important to many of her patients, Villarreal said.
“In our Hispanic culture, there’s a strong faith component,” she said. “Talking about that with my patients … there’s a sense of comfort in it.”
Leibert said his patients rarely turn down the chance to pray with him when asked. He has prayed with people of all faiths and doesn’t try to change their beliefs, he said.
Separation of church and medicine?
Some experts, however, are concerned about doctors bringing religion into office visits and the possible ethical implications.
When questions about religion turn into evangelism, or when a patient feels pressured to pray or conform to the doctor’s beliefs, that’s when the inquiries cross the line, said Richard P. Sloan, psychiatry professor at the New York-Presbyterian Hospital at Columbia University Medical Center in New York. Sloan is the author of Blind Faith: The Unholy Alliance of Religion and Medicine.
“That’s capitalizing on the vulnerable status of patients,” Sloan said. “We want patients to do what physicians say when it comes to medical matters. … When (doctors) pursue a different agenda, a religious agenda, it’s a real danger.”
Questions about religion can invade patients’ privacy and also cause feelings of guilt and remorse — hardly a burden a sick person needs, Sloan said.
“There are substantial ethical concerns in trying to link religion to medicine,” he said.
Krishna said he thinks prayer in the doctor’s office is a good idea only if the patient’s beliefs are consistent with that practice.
“If we’re imposing our belief system on them, then it’s crossing the boundary,” he said. “We live in a world where people believe different things, and boundaries are important.”
Doctors should inquire about patients’ spiritual beliefs, whatever they are, Krishna said.
Having that information can help doctors offer better advice and help establish a connection with the patient, he said.
Properly used, spirituality is a valuable tool in health care that could improve outcomes for many people, Krishna said.
“It has enormous healing potential,” he said. “It’s a complement for modern medicine, not a replacement.” ____ Melissa McEver covers health and environment issues for Valley Freedom Newspapers. .
Religious Doctors No More Likely to Care for Underserved Patients
Newswise — Although most religious traditions call on the faithful to serve the poor, a large cross-sectional survey of U.S. physicians found that physicians who are more religious are slightly less likely to practice medicine among the underserved than physicians with no religious affiliation.
In the July/August issue of the Annals of Family Medicine, researchers from the University of Chicago and Yale New Haven Hospital report that 31 percent of physicians who were more religious—as measured by "intrinsic religiosity" as well as frequency of attendance at religious services—practiced among the underserved, compared to 35 percent of physicians who described their religion as atheist, agnostic or none.
Physicians have many compelling reasons to avoid spending the bulk of their time caring for the poor. It can mean forgoing professional prestige, free time and academic opportunities. It often comes with reduced salaries, decreased support staff and constant bureaucratic interference.
But physicians who care for the underserved receive intangible rewards in exchange, such as a sense that they make a difference in society, have a positive impact on the lives of large groups of patients and have aligned their jobs with their altruistic aspirations.
To find out which religious, spiritual and personal factors were most often present in doctors who care for the underserved, Curlin and colleagues surveyed 1,820 practicing physicians from all specialties; 1,144 (63%) responded.
The survey contained questions about what the researchers called intrinsic religiosity—the extent to which individuals embrace their religion as the "master motive that guides and gives meaning to their life." Physicians were asked if they agreed or disagreed with two statements: "I try hard to carry my religious beliefs over into all my other dealings in life," and "My whole approach to life is based on my religion." They were also asked how often they attended religious services.
The survey also included questions about whether the physicians considered medicine a calling, whether their religious beliefs influence their practice of medicine, and whether the family in which they were raised emphasized helping those with few resources.
The researchers found that 26 percent of physicians reported that their patient populations are considered underserved. These physicians tended to be younger and were more likely to report working in an academic health center and receiving loan repayment in exchange for working where they do. Physicians who receive educational loan repayment are often obliged to work in underserved communities.
Physicians who strongly agreed that their religious beliefs influence their practice of medicine were more likely to report practice among the underserved. However, physicians who were more religious in general (as measured by their intrinsic religiosity or their frequency of attending religious services) were not more likely to practice among the underserved. Even the more religious physicians who reported that their families emphasized service to the poor and that, for them, the practice of medicine was a calling, were no more likely to practice among the underserved.
Curlin and colleagues also noted that those who identified themselves as very spiritual, whether or not they were religious, were roughly twice as likely to care for the underserved as those who described their spirituality as low. "Part of this divergence between religion and spirituality can be traced to a rift between Christian denominations in the late-19th and early-20th centuries," explained Curlin, who describes himself as an orthodox Christian in the Protestant tradition.
About a hundred years ago, he said, many of the mainline and liberal Protestant churches began "to emphasize efforts to right social injustices, while the more conservative churches tended to stress doctrinal orthodoxy. Research indicates that those who consider themselves spiritual but not so religious are more likely to be formed in the more liberal denominations."
Policy makers and medical educators hoping to increase the physician supply for underserved populations should take these results into account cautiously, said the authors. "No one knows how to select medical students in a way that would actually increase the number of physicians eager to serve the underserved," Curlin said, "but our findings suggest that admissions officials should ignore both the general religiousness of candidates and their professed sense of calling to medicine."
The Greenwall Foundation and the Robert Wood Johnson Clinical Scholars Program funded this study. Additional authors include John Lantos and Marshall Chin of the University of Chicago and Lydia Dugdale of Yale New Haven Hospital.
Doctors incorporating spirituality into their medical practice
By MELISSA McEVER The Brownsville Herald July 15, 2007
Dr. Bruce Leibert makes no apologies for who he is: a devout, outspoken Christian doctor who asks to pray with patients and asks them about their spiritual beliefs. And many of his patients like him that way.
Leibert, program director of Valley Baptist Family Residency in Harlingen, openly incorporates spirituality into his practice because he believes it makes a difference in patients’ physical and mental health, he said.
“A lot of studies talk about this … how important this part of health is to people, and how often doctors ignore it,” Leibert said. “Health must address not only body, not only the mind, but the undying soul … If I can’t minister to the soul, then I can’t do medicine.”
In the past, a clear boundary has existed between religion and medicine: chaplains and pastors visited hospitals to attend to patients’ spiritual needs, while doctors and providers were expected to solely treat the physical. That line between faith and science is starting to blur, though, as more health providers and hospitals are incorporating spirituality into patient care. From Bible studies for health-care workers to prayer time with patients to meditation classes at hospitals, faith is playing a more prominent role in the health-care setting, and for a good reason, experts say.
“Science is telling us clearly that when you activate your spirituality, various things happen in the body that help you heal better in times of disease and distress,” said Dr. R. Murali Krishna, president of the James L. Hall Center for Mind, Body and Spirit in Oklahoma City. Krishna and others founded the center 10 years ago, hoping to increase patient awareness about the mind-body connection, he said.
“We don’t really talk about one particular religion or dogma — what we talk about is spirituality, connecting with a higher power,” Krishna said of the center’s focus. The center offers seminars on meditation, guided imagery and relaxation, in part to help people achieve that connection, he said.
“It helps you access the healing power within yourself,” Krishna said.
Connecting mind, body and spirit.
Researchers have actively studied the mind-body connection since the 1960s, according to the National Center for Complementary and Alternative Medicine, part of the National Institutes of Health. Studies have suggested that mind-calming practices like meditation, yoga and visualization can help reduce chronic pain, improve immunity, speed wound healing and reduce stress, which in turn improves health.
More researchers are now looking into whether similar results come from prayer, church attendance or strong belief in a religion. Some studies have indicated that spiritual beliefs and practices can improve the mental and physical health of the chronically ill and sick elderly, improve patients’ ability to cope with pain and distress and protect against depression.
Patients seem to want to talk about spirituality and faith with their doctors, according to a 2004 survey that appeared in the Annals of Family Medicine. The survey found that 83 percent of respondents wanted their doctors to ask about their spiritual beliefs, and a majority wanted those beliefs to be considered when planning treatment.
Some local doctors routinely take a “spiritual history” of their patients. Leibert, of Family Practice Residency, often asks questions like “Do you go to church regularly?” and “Do you pray?”
A spiritual history can help doctors tailor treatment to the individual patient, said Dr. Linda Villarreal, an Edinburg internist. If a patient is suffering from symptoms related to stress, for example, she’ll suggest prayer or meditation depending on what the patient believes, she said.
Leibert said his patients rarely turn down the chance to pray with him, when asked. He’s prayed with people of all faiths and doesn’t try to change their beliefs, he said.
“I don’t go into the office to change them — I just go to love and care for patients,” Leibert said.
Separation of church and medicine?
Some experts, however, are concerned about doctors bringing religion into office visits and the possible ethical implications.
When questions about religion turn into evangelism, or when a patient feels pressured to pray or conform to the doctor’s beliefs, that’s when the inquiries cross the line, said Richard P. Sloan, psychiatry professor at the New York-Presbyterian Hospital at Columbia University Medical Center in New York. Sloan is the author of “Blind Faith: The Unholy Alliance of Religion and Medicine.”
Sloan said that questions about religion can invade patients’ privacy and also cause feelings of guilt and remorse — hardly a burden a sick person needs, he said.
“There are substantial ethical concerns in trying to link religion to medicine,” Sloan said. “Nobody, least of all I, want to dispute that religion brings comfort in times of difficulty. But that doesn’t justify bringing religious practices into medicine. The best solution is for (doctors) to allow people to express their religion without interference.”
Krishna, of the Hall Center for Mind, Body and Spirit, said he thinks prayer in the doctor’s office is a good idea only if the patient’s beliefs are consistent with that practice.
Doctors should inquire about patients’ spiritual beliefs, whatever they are, Krishna said. Having that information can help doctors offer better advice and help establish a connection with the patient, he said.
Sloan agreed that there is a place for faith in the health-care setting — but it isn’t the doctor’s office, he said. Chaplains should be the ones to discuss spiritual issues with patients, he said.
Villarreal, the Edinburg doctor, agreed that when doctors bring religion into their office, “there’s a line you could potentially cross.” That’s why she makes a point of asking patients about their beliefs, and not discussing religion or spirituality with them unless they’re comfortable with that terminology.
Properly used, spirituality is a valuable tool in health care that could improve outcomes for many people, Krishna said.
“It has enormous healing potential,” he said. “It’s a complement for modern medicine, not a replacement.”
Xerpi