Why would a terminally ill patient, described by self and family to be a dedicated church-goer, refuse prayer? That was a question one of our clinical pastoral education (CPE) students recently encountered when he was summoned by a family to pray for their loved one at Washington Adventist Hospital.
As it turned out, the patient had adamantly refused the prayer offer but was quite receptive to the offering of a nonjudgmental and compassionate ear. During his stay, he shared several personal stories that provided insight into the events that had shaped his outlook on faith and life. The most telling event was the passing of his mother.
She had passed away from a terminal illness when he was a young adult. He had prayed earnestly for her but it was apparent from the emotional manner in which he told his story that he had never gotten over the disappointment of her death. As he repeatedly referenced this event, it became clear that he had never finished grieving for her. This old burden, coupled with his experience that prayer was unreliable, was adding stress to his current illness causing him to lose faith and hope.
I share this story because it is the perfect illustration of what it means to engage in the study of the “living human document.” The living human document is a term we in health care use in the practice of clinical pastoral care. It refers to the act of listening to a person’s story and hearing the references to the experiences that have shaped that person's faith and outlook on life. These references provide valuable clues to the underlying issues that compromise hope and faith. They also help us determine the right kind of support to offer.
As in the above case, the patient’s objection to prayer was just a symptom of a much deeper struggle within. From this understanding, it was determined that grief counseling was what he needed. The counseling proved to be quite effective. Not only did the patient become less agitated but he also requested prayer in his remaining days. When he passed, he passed with a greater sense of peace.
In the 1920s, Anton Boisen, a pioneer in hospital chaplaincy and CPE, was the first to coin the term living human document in reference to the understanding of a patient’s theological needs. The living human document has since evolved to become a catch-all term in regards to understanding the theological, psychological and social needs of patients.
Science has proven that a relationship between faith and health does exist. By measuring the body’s physical response to stress, studies have shown that individuals who rely on a belief system to help them cope struggle less in a health crisis and have better physical outcomes with quicker healing times. It’s also been demonstrated that individuals who struggle with their belief system are at risk for complications with longer healing times.
Our ability to apply this knowledge in health care, however, is largely dependent on our ability to get to the heart of an individual’s story. While CPE students are already engaged in this discussion as part of their training, we need to engage all members of the health care team in this dialogue because there are lessons in the living human document that can improve the delivery of quality, compassionate care.
Ismael Gama is Associate Vice President of Spiritual Care and Mission Integration
for Adventist HealthCare, a large, faith-based health care organization based in Rockville, Md.
