Before I began the operation, my patient asked, 'Could I say a prayer first?' I felt a little uncomfortable at first.
The young woman was scheduled to have the fluid drained at the hospital. I met her the morning of her procedure. “I read your CT scan a few days ago, and just reviewed it. Did your oncologist explain what it showed?”
“Yes. She mentioned a new fluid pocket.”
I must have gestured that I would elaborate on her scan’s abnormalities, but she spoke before I could continue.
“Before we go any further, there’s something I need to explain. My husband and I are believers. We’ve prayed a great deal, and have family and friends at church praying for me. We try not to use the ‘C’ word, but as far as I’m concerned, my body is cancer free.”
She looked calm and rational on the surface, but she was completely wrong about the state of her internal organs. I did not point out that her self-perception did not match her CT scan. I feared she might forego potentially beneficial treatment in her denial.
“Now, I’m doing everything the doctors are telling me to—surgery, chemotherapy, all of it. But this is what I feel, and what I need to believe to get through this.”
“Fair enough,” I replied, relieved that I could better understand her outlook. Her approach was different than most, but that did not make it wrong. She was not accurate about being cancer free, but on some level she knew that, even if she would not outwardly admit it.
She signed the consent form, set the pen on the clipboard, and smiled at me again. “I’ve got faith,” she said, “and I’m putting it in your hands today.”
The technologist scanned the woman’s pelvis, and I used the images to decide where best to insert the needle. “We know just where to go,” I reassured her, drawing an “X” on the skin of her lower abdomen with a magic marker. “We’ll get started now.”
“Before you do,” she asked, “could I say a prayer first?”
“Of course.” I had seen many patients over the years briefly lower their heads in silent meditation, never needing to ask permission.
It turned out that this woman’s prayer was neither silent nor brief. I was standing on one side of the table, my assistant on the other. The patient extended both of her arms, gesturing that we each hold one hand while she prayed aloud. We each took a hand so that the sick woman could begin.
I felt a little uncomfortable at first. Despite a natural interest in humanity and spirituality, outward prayer to me is still a somewhat personal matter, particularly at work. I have never believed that my own religious views or questions are the business of the patients I treat. Awareness of patients’ beliefs can be important, if it helps tailor treatments to their needs, but being asked to participate in her prayer was slightly unusual and made me feel a bit awkward. From the atheist to the devout of all faiths, I try to treat everybody with the same concern and dignity, as do most doctors I know, without openly bringing my own religion to the equation. When I reached for this woman’s hand, I feared that my religious privacy might somehow be compromised. The woman, her health, and her faith should be center stage. I only wanted to play a supporting role.
The young patient surprised me yet again. After we bowed our heads with her, she began her spoken prayer. I could tell she was going to talk longer than most strangers would normally pray aloud. The more she talked, the more I found myself relaxing, understanding that the prayer was not about me, other than her expressing thanks for what I might be able to do for her.
“Dear Lord,” she began, “I first want to thank you for all of your grace. Thank you so much for guiding these people in their care for me. Thank you for all of this amazing technology and for all of the opportunities you have provided in helping medical care advance so far. It’s just so amazing to think of what these people can do with what you’ve provided, and so amazing to think of all of their education and training that has allowed them to be able to help me and so many others. Thank you for their talents and intelligence and caring as they use your gifts in their work, today and every day.
“I pray that your hands will guide theirs in their efforts to help continue to cure me of this disease,” she continued. “I ask that you guide us all here so that everything goes smoothly. It really is just incredible, as all of your blessings are, and we all thank you for the glory that you provide. Thank you so much for all of your help in my recovery.”
I was impressed with her gratitude and sincerity. Her denial of the CT scan findings was still foreign to me, but it did not matter anymore. She was not truly delusional; she simply had to believe that she would be healed. She was positive, gracious, and genuine. She approached her disease with the medical understanding that she could not outwardly admit, and with the religious conviction to which she clung in her time of need.
“As always,” she concluded, “thank you for the love of my family and friends, for my faith in you, for the support of my church, and for all who seek to serve you and perform your work. We continue to ask for your guidance and understanding as we pray to you, Lord. Thank you, Jesus, my savior, for all that you do always, for all of your blessings. Thank you for your help and love and for guiding me through this ordeal. In your name we pray, Lord, Jesus Christ. Amen.”
“Amen,” the CT tech across from me replied softly, nodding her head once, then raising up from her bowed position. I wondered how much her reply was from the heart, or how much was for the benefit of the patient. I’ve never been sure if it would be appropriate to ask.
“Amen,” I echoed, afraid of waiting any longer.
The patient and her prayer left me feeling surprisingly comfortable. I had just been subjected to witness and participate in her religious beliefs, which might have been unsettling in another context. Yet, the gratitude and peace that she emitted left me feeling tranquil, clearly focused, and somehow empowered. Some might wonder if the prayer’s power resulted from a higher intervention. Not qualified to confirm with certainty, I can say that the three of us present felt the confidence and power to perform the task at hand. We were helping her, and she was helping us to help her, without anyone assuming or forcing any beliefs on the other people. She may have needed to be overtly religious, but in essence only asked that we be supportive by allowing her an outward expression as we all reflected internally.
The drainage went reasonably well, but not ideally. The cancerous fluid was too complex. “Do you feel any improvement?” I asked.
“Yes,” she said. “The pain’s not gone entirely, but there’s less pressure now.”
“There’s more,” I explained. “but it’s hard to get. It wouldn’t make sense to keep sticking you, if we can’t get enough to justify the risk and discomfort.”
“You tried your best,” she said. “That’s all any of us can do. Thank you.”
I never met her again. About two months after the day we met, I saw her obituary in the newspaper.
I still wonder sometimes if she helped me more than I could help her, and hope her faith sustained her somehow, even if she did not get the ending she wanted. She reminded me that the spirit is part of a shared approach to healing, even if specific beliefs are as personal and unique as each individual.
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Dr. Cullen Ruff is in private practice and an assistant professor of radiology at Virginia Commonwealth University. A member of the Unitarian Universalist (UU) Church of Arlington, Virginia, he is at work on a book, Looking Within: Imaging the Body, Exploring the Human Spirit.
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