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Getting a Patient's Whole History
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.
By Ismael Gama |
July 22, 2008; 4:22 AM ET
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Posted by: Thomas Baum | July 24, 2008 12:20 PM
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"Science has proven that a relationship between faith and health does exist."
Science has also proven that a relationship between placebos and health does exist. Turning the placebo effect into a career for injecting religious doctrine into healthcare is a bad idea.
Just because YOU thought prayer should happen before a person dies ignored the wishes of the dying person. You went from a minister to being a doctor to being a psychologist. I can just imagine the anguish this poor man had having to deal with you by his bedside probing him with questions about his mother's death. Can't you people leave other people alone, especially in such dire times, and respect their wishes? Or do you ALWAYS know best?
Posted by: Fate | July 24, 2008 11:39 AM
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Tell you one thing, preacher. It shouldn't be *me* the one sitting there watching the light going out of my Christian relations' eyes and 'forgiving' them for all the *ahem* they put me through in some desperate attempt to please the likes of yourself.
It should be *you.*
Reverend.
Easier with strangers.
So shut up and listen.
Posted by: Paganplace | July 23, 2008 6:56 PM
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"Why would a terminally ill patient, described by self and family to be a dedicated church-goer, refuse prayer?
"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. "
Cause people being in the process of dying is not the time for you to mutter your words at them? It's *their* time.
You get to preach at them all their lives and about them as long as you like. You shut up and you be there and you listen, that's what you do.
And when they ask you be whoever you need to be.
But you listen.
This is what death is.
Posted by: Paganplace | July 23, 2008 5:30 PM
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>Science has proven that a relationship between faith and health does exist.
Repeating a lie does not make it true.
Posted by: khefera | July 23, 2008 4:31 PM
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ISMAEL GAMA
After reading your post and then the replies, I got the impression that some of the people must have read a different post than I did.
It sounds to me that the CPE did listen and thought about what his fellow human being, the patient, was saying.
I would like to make a comment about the patient not wanting prayer, it seems that he might have thought of prayer how some people think of prayer as in God being at our beck and call to do what we want Him to do.
Also the CPE did pray with him considering that prayer is suppose to be communication and the CPE took the time to actually listen to the patient and talked 'with' him rather than 'to' him.
Another thing that I would like to say about prayer is that sometimes we get so caught up in the "pre-fab" prayers that we forget that prayer should come from the heart and mind and can and should be in our own words, not that "pre-fab" prayers aren't important and exquisite, I might add if we let them sink into our hearts, but there is a difference between saying a prayer and praying a prayer.
Take care, be ready.
Sincerely, Thomas Paul Moses Baum.