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A Piece of My Mind
February 18, 2020

Finding Faith

Author Affiliations
  • 1St Jude Children’s Research Hospital, Memphis, Tennessee
JAMA. 2020;323(7):609-610. doi:10.1001/jama.2020.0580

My parents tell me that I began questioning my faith at a young age. As one story goes, when I was 4 years old, a pet fish at my preschool died. My father heard me crying in my room later that night. When he entered to ask me what was wrong, I replied, “What's the point of living if we are all going to die?” My father, a medical oncologist, thought for a moment. Then he responded quietly, “That’s not a very unique question.” According to my parents, I digested this information for a few seconds, then lay down and fell into a satisfied sleep.

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    13 Comments for this article
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    Thank You
    Sam Cooper |
    Beautiful description of one's journey of faith. Your connections made with patients and families is truly sacred.
    CONFLICT OF INTEREST: None Reported
    Thank you
    Mike Maas, MA | Self
    Burdened by the burden of proof yet aware that there is more yet burdened by the lack of evidence. What an endless circle yet you have offered a way out. Just what I needed to hear again.
    CONFLICT OF INTEREST: None Reported
    Kol HaKavod
    Lesley Shure, MD | Private Practice, Orthopedics, San Antonio Texas
    Just to share an example of my own: An elderly lady with painful, fresh distal radius fracture shared her faith in me, allowing me to recognize where my upbringing, both Jewish and musical, might overlap. I asked whether she was familiar with The Shema, Deuteronomy 6, and the paragraph that followed. I recited it in English, then asked her permission to chant the Hebrew. It provided fascination, comfort, and distraction, while I set and braced her fracture. She appreciated it so well, she had me do it twice.

    Like yourself, when patients or their
    families requested my own contribution to their spiritual support, it was as strange and awkward as anything I could imagine. To reconcile the cognitive dissonance, I learned to ad lib prayers that comfort, while avoiding terms that are too specific to any one faith, so that each person around could add that particular aspect as needed, to suit their own style.

    Writing this reminds me that I did the same, later, as Jewish Lay Leader at Andrew Air Force Base, tasked to produce writings and presentations for the wing and/or the entire base. Hopefully, the result reflected a combination of "tikun olam" ("repairing of the world") and "E Pluribus Unim." Deity optional.
    CONFLICT OF INTEREST: None Reported
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    Thank you!
    Prevesh Rustagi, MD |
    The most beautiful article on spirituality that I have ever read!
    CONFLICT OF INTEREST: None Reported
    Thank You
    Edward Taub | Family Physician and Board Certified Pediatrician
    I've felt compelled to read and re-read this essay 3 times in the last 12 hours since first seeing it, each time feeling more deeply touched by relating it to my own experience with patients. Also, as a secular Jew, I understood my "Jewishness" more deeply than ever. Thank you, Dr. Kaye!
    CONFLICT OF INTEREST: None Reported
    A challenge with comfort
    Geraldine Powell, MB Bch, BAO | none
    The best explanation I have ever read on the nature of God, whomever or whatever she is.
    CONFLICT OF INTEREST: None Reported
    The Essence of Faith is ....
    Robert Henkin, BA, MD | Loyola Medical Center, Maywood, IL
    I am old now, having practiced medicine for over 50 years now. As a Jew in a Catholic medical center I had the opportunity to observe faith from a unique perspective. Faith is a necessary component of life. Without it we have little hope things will ever be better than they are now. Faith in a physician’s life offers us a way to explain to ourselves things we cannot explain based on science. An old friend who was perhaps the best technical surgeon I have ever met put it this way: “Sometimes I go in there and do everything right and it turns into a disaster. Other times I make mistakes yet everything comes out great.”

    In his own way he was acknowledging that there are things beyond his control in play. Faith can be very difficult to rationalize. I have been married to two of most wonderful women, each of whom died at a young age from cancer. Almost all human groups, even the most primitive, have deities they pray to. It is a way of dealing with the unknown and inexplicable. At the worst periods of my life my faith was there telling me I don’t have to understand everything that happens.

    Faith by its very essence is accepting that we cannot explain everything, but our faith consoles us that we're not meant to understand everything. Even as science moves forward we acknowledge we cannot control or explain everything.
    CONFLICT OF INTEREST: None Reported
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    Like a smooth stone falling through deep water
    Judith Grisel, PhD | Professor of Psychology & Neuroscience, Bucknell University
    This is the best thing I've read in months. There is nothing like standing toe-to-toe with suffering for illuminating our deepest truths. Thank you for your honesty and your beautiful writing!
    CONFLICT OF INTEREST: None Reported
    Illuminating thoughts for physicians in training
    Danilo Blank, Full professor | Department of Pediatrics; Faculty of Medicine; Universidade Federal do Rio Grande do Sul; Porto Alegre, Brazil
    Thanks for an indeed enlightening piece, which illustrates how faith and empathy link; an essential asset to teach medical students. It is quite interesting the way you — a secular person — equate faith with togetherness and an affirmative drive. Coincidentally, I — who come from a non-religious Jewish background too — have lately been asking my students in an introductory course in child health promotion to correlate Arlen & Mercer’s “Accentuate the Positive” with an affirmative look at social determinants of health (an idea I borrowed from Edward Schorr’s article in JAMA Pediatrics). The song talks about saying “yes”, but also about faith. This semester I will include your text in their class work.
    CONFLICT OF INTEREST: None Reported
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    An atheist's perspective
    Ajit Damle, MD | CV Surgery
    I was deeply moved to read this "A Piece of My Mind" in JAMA.

    I am a retired cardiothoracic surgeon, and a lifelong atheist. Practicing in an upper mid-western state, I too joined prayers with the patient's families but without conviction or enthusiasm. But later in my career, I arrived at the same conclusion as Dr. Kaye did.

    I used to look at religiosity with disdain and contempt. Not any more. Now I see how, to billions of people, God and prayers give comfort, hope and meaning to their lives. I still am an atheist, but now
    understand that compassion for our fellow human beings requires empathy and understanding. I wish I had so felt at the start of my practice.

    Thank you for putting it so eloquently. I am forwarding this article to my two sons and daughter-in-laws, all four surgeons and atheists. Will they understand?

    Thank you! And for want of a better way to put it, God bless you!
    CONFLICT OF INTEREST: None Reported
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    Wonderful Description of Spirituality!
    Gregg TeBeest, MDiv, APBCC | Health System, Hospice Chaplain
    Even as a healthcare chaplain I couldn't have articulated the meaning and value of spirituality in healthcare any better than Dr. Kaye has done. I wish every physician could read her article. Thank you Dr. Kaye for your honesty, for your contribution to your profession, and most importantly for the holistic care that you provide your patients!
    CONFLICT OF INTEREST: None Reported
    Mens agitat molem
    Pandiyan Natarajan, M.B.B.S., M.D., M N A M S | Department of Andrology and Reproductive Medicine, Chettinad Super Speciality Hospital, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India- 603103
    Thank you very much for that wonderful article. I am an agnostic since my 13th year, which is what I think most people are, though very few would be willing to admit. But your faith or lack of it should not in any way interfere with your caregiving job. We are caregivers first and foremost, healers some times, and curers rarely, and we can do a better job at all this when we attend to the mind as well as the body.

    I am in the field of obstetrics and gynaecology since 1977 and in the medical field for
    close to 50 years. For the last 35 years I am practising full time andrology, Reproductive Sciences and Sexual medicine. I am involved in the practice of in vitro fertilisation and embryo transfer, preimplantation genetic diagnosis and other advanced reproductive technologies. I am amazed to observe the enormous influence mind has over the body. Modern medicine has started recognising this only very recently. We are increasingly aware of the power of placebo.

    Faith is a powerful healer. Patients come to us with faith. Our action should sustain that faith and enhance it. A sick person is not the one to be taught rationality, as long as his or her faith does not affect his well being and recovery. Debate on God and religion should be outside institutions of healing and physicians as care givers should not engage in this debate while providing care. Whether we should participate in faith-based practices is no longer a point to be debated. If the patient feels that this will help in their healing and if it is not contraindicated medically, I think we should set aside our belief or lack thereof and participate in the patient's healing system. Of course we can excuse ourself, if we can do so without hurting or disappointing the patient. People are very sensitive about their religion and faith.

    But conflicts do occur. Some practices based on age-old faiths and traditions harm the patient and the baby and patients need to be coaxed out of it through reasonable, rational, evidence-based persuasion and not by getting into a huge argument. At other times our faith may conflict with patient's faith. We should give in to help the patient as long as it does not undermine our core values.

    A doctor and a health care institution today are judged by patients not by their efficiency or by their look alone. They are judged by how well they attend to the emotional needs of the patient. Some institutions have learnt this and have incorporated places of worship and relaxation in their premises. Others are ignoring this to their peril and to their patients' dissatisfaction.

    Medicine needs to move from the mechanistic approach to the body to Mind-Body medicine and attend to the emotional needs of the patients. In the present world on a treadmill, where you have to run to be in the same place, where time is a big constraint, where numbers and bottom line are more important than care, compassion and empathy, Mind-Body Medicine may be an utopian idea.

    Mind is a powerful weapon in healing, curing, ameliorating and alleviating. Faith is a construct of the human mind and is often socioculturally determined based on culture, tradition, religion and nationality. Health care should not be in conflict with any of the above, if it were to provide optimum services.

    To conclude, the article has touched an important area of health care which is hardly if ever taught inmedical school. Incorporating mind and faith in the healing process would enhance & enrich the experience of the caregiver and the cared and heathcare would move to become holistic and not fragmented.
    CONFLICT OF INTEREST: None Reported
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    Another Comment on Faith
    Kim Poulton, RT(R)(MRI) | Retired, University of Utah Hospital
    I wanted to offer a first hand conversation between me and a dear friend. My friend’s husband was dying from pancreatic cancer. At a particularly low point in his illness, he asked the inevitable, “What did I do to God to make Him do this to me?” My friend’s answer profoundly changed my own thoughts on that question. She said, “God didn’t do this to you. We are all imperfect bodies in an imperfect world. God knows this and is there for us now and will be with us in the afterlife where there is no suffering.” It was about that time I read Rabbi Harold Kushner’s, “Why Bad Things Happen To Good People”. If you haven’t read it, I highly recommend it! My friend’s journey and Rabbi Kushner’s journey positively affected me and the question most everyone has, i.e., if God loves us, why does He let us suffer? Thank you for sharing your spiritual journey with us. I hope your new way of connecting will be shared by others.
    CONFLICT OF INTEREST: None Reported
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