Prayer and Care: Faith as a Form of Culturally Competent Care.

Abstract

As I walked into the examination room I saw my patient, an elderly Russian woman, lying on the stretcher, weeping. A young woman, her granddaughter, sat in a chair to the side, crying and repeatedly stroking her grandmother’s hand. All I had been told was that this patient needed a consult for a finger laceration. But the crying in that room spoke of something different than purely physical pain. Almost hesitant to discover what that was, I attained the history through the patient’s granddaughter, who translated fluently between Russian and English and stopped only to comfort her grandmother or to collect herself through her own tears. She told me that the older woman, Ms. S, had just seen her eldest son die by suicide. He had taken a knife with clear intentions and Ms. S, in desperation, had tried to grab the weapon from his hand. She was unable to stop him and suffered a sizeable laceration in the process. The granddaughter was home at the time and had watched all this happen. By this point in medical school I had developed (what I considered to be) basic competencies in both suturing and bedside manner. But I felt completely helpless after listening to this story. I could try and repair Ms. S’s laceration but I could never restore what she had lost, and even hope seemed tenuous. Not long after the granddaughter finished relaying the history, a middle-aged man entered the room. He was the youngest son of Ms. S. He bent down to hug his mother on the emergency stretcher, and almost immediately—and in complete sincerity—he reminded her of their Christian faith, their held promise that things would be well. He shared hope for peace and healing for his older brother after so much torment, and Ms. S, soaked in grief, smiled and then cried. After a long silence, I looked at her son and told him that I admired his faith. He looked at me and asked if I was a Christian. I nodded and showed him a tattoo of a cross on my right wrist. He smiled and asked if we—all of us—could pray together. I said yes, and after the prayer and a brief physical examination of Ms. S, the son hugged me and thanked me for my care. I am aware of the complexities and divisions within religious life in America. When I was a medical student, I tried to be thoughtful and professional about where and how I mentioned my faith, and the same is true for me now as a resident in orthopedic surgery. My goal is to provide the best, most inclusive and culturally competent care for my patients, regardless of age, sex, race, or belief. For that reason, faith is not something I talk about often at work. But neither is it something I can ignore. Not because it is my faith, but precisely since it is not solely mine; because it forms the core of so many of my patients’ lives. Faith is relevant to the clinical interaction when it gives patients and clinicians a shared ground upon which to stand in the midst of chaos, and my experience with Ms. S showed me that spirituality can effect healing when all else fails. It is not, of course, incumbent on any individual clinician to offer that healing. But I believe that a selfless prayer or caring affirmation may have its place for those who find themselves able, in good faith, to share it with patients.