Saturday, February 9, 2013

A Doctor's Prayer

The following is an awesome article by Marjorie Ordene featured in Tabletmag - I love its honesty and moderns sense of struggle.  I think it raises a great point regarding how tefilla, when it breaks out of the synagogue into one's professional and personal world, feels a more significant tool for an individual to connect to God.
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Praying for My Patients
As a doctor, I know there’s a power higher than me. That’s why I pray every day for the people I’m treating.
By Marjorie Ordene| February 7, 2013 7:00 AM |

Fifteen years ago, my husband came home from the daf yomi Talmud lecture he attended every day and proclaimed: “All good doctors go to hell.”

As a holistic doctor —and, I thought, a good one—I was taken aback. “Why would good doctors go to hell?” I asked. Brought up in a secular Jewish home, I had always believed in a rational, scientific world where doctors were treated with a certain respect or even awe. I had only become observant a few months before my marriage to Ethan, who’d been raised in a religious home. I wondered if this belief about doctors was common wisdom among observant Jews.

Seeming to relish my surprise, Ethan eagerly explained, “The good doctors go to hell because they don’t pray for their patients. They believe they’re doing the healing.” He waited for his words to sink in before asking, “And what about you?”

The question has stayed with me ever since. I took his point to heart and decided, after some reflection, to try bringing prayer into my medical practice. It didn't come naturally. At first, the idea of praying for anyone reminded me of my religious Christian friends, who were always offering to pray for me—which I found vaguely annoying. But then my aunt became ill and slipped into a coma. I remembered seeing my mother-in-law praying for people by name when she lit her Shabbos candles, so I decided to give it a whirl. After six weeks, my aunt recovered.

That convinced me. Ever since, I've prayed for my patients every day.

***
Growing up as a secular Jew, I had never put much stock in the power of spirituality until I took a trip to England in 1989 and stayed with my brother’s wife’s cousin, Aubrey Rose, who introduced me to a family secret: Aubrey and his wife claimed to have communicated repeatedly and reliably with their dead son David through a medium. I was so impressed with this new insight that I vowed to explore the hidden spiritual side of things—in general, and in a Jewish context. I started attending a Conservative egalitarian synagogue and, when that didn't satisfy (religion ended at the shul door), moved on to an Orthodox one.

Around the same time, my professional life as an M.D. was also shaken up. I was working at a small, not-for-profit clinic that offered alternative services like acupuncture and biofeedback. To fulfill my continuing medical education requirement, I attended a seminar in nutritional medicine at The Omega Center, a former Yiddish summer camp in Rhinebeck, New York, now serving as a retreat for holistic studies. But before settling into my assigned course, I first sat in on classes on qi gong, yoga, and mindfulness. When I returned to the clinic, I began to put my new spiritually informed medical training into practice, eventually leaving that office to open one of my own.

It was also around this time that I, a newly observant Jew, was introduced to and married Ethan.

When Ethan later made his big pronouncement about “good doctors,” I had already been praying for five or six years and practicing holistic medicine for nine or 10—but I hadn't thought about how the two might fit together. Mixing prayer with medicine can be awkward. It’s one thing to daven privately, but to introduce prayer into the doctor-patient relationship crosses a line, almost like breaching the separation of church and state. What right do I have to speak to a patient about God? What if he is an atheist?

I had read of studies showing that prayer promotes healing, but it wasn't until my aunt’s miraculous recovery that I began to consider prayer on a more personal level. Something shifted inside me. I had moved from being someone who felt uncomfortable praying for anyone to someone who felt a desire, even an obligation, to put in a good word for those who suffered. As I sat at my kitchen table each morning, I would add the names of ailing people to my prayers. I started with my parents and elderly relatives, then added the names of people I’d heard about in the community, and finally, tacked on “and all my patients,” at the end of the list. I was determined not to be one of those “good doctors” who didn't pray for her patients.

The first time I prayed for a specific patient was when a woman with ovarian cancer gave me her Hebrew name and asked me to pray for her. I added her name to my list. Later, when another Jewish patient was diagnosed with uterine cancer, it seemed appropriate that I inquire after her Hebrew name. Although not religious, she readily told me her name, Nechama, but she had to email me later with her mother’s name, which she gave as Laura. In both these cases, I was not actively treating the patients for their life-threatening condition; as a holistic physician, the conditions my patients see me to treat are rarely life-threatening.

Over the years, I've noticed that praying draws me closer to God, and it also brings me closer to my patients. If I prayed for a patient in the morning and she walks in during the afternoon, I feel a special connection, like seeing a long lost friend. I think this works both ways, like the patient who regularly calls me and begins by saying, “Hey, Doc, it’s me, Miriam bas Esther.” She knows I’m praying for her.

There was one patient, though, I couldn't help. She was suffering from terrible anxiety—so much so that she was too anxious to try any of my treatments. This patient I prayed for. I never told her, just added her name to my list. Sadly, the one treatment she wanted was estrogen, and when she later developed breast cancer, she became convinced that it was the estrogen I prescribed that caused her cancer. She decided to sue me.
Now I faced a conundrum: Should I still pray for her or drop her from my prayers like a hot potato? I decided to wait for Shabbos and ask my brother-in-law, who is a rabbi. Upon hearing my story, his answer came swiftly: “You can tell her to go to Hartford, Hereford, and Hampshire! Do not pray for her; and if she ever wants to come back, do not see her!” I dropped the potato. If the Almighty wants to heal her, I figured, he will—with or without my prayers.

***
I’d love to report all my successes with prayer, but unfortunately I’m not aware of any. Some patients—including the woman with ovarian cancer, an elderly gentleman with urinary retention, and an octogenarian with Alzheimer’s—are doing reasonably well, but I can’t say it’s because of my prayers. The patient with uterine cancer passed away. But in fact, it’s the very nature of prayer that we don’t always get what we ask for. That doesn't mean our prayers aren't answered; they are, just not in the way we expect. Still, no matter what the outcome, I know patients take comfort in having someone pray for them.

Offering to pray for a patient can feel like an admission of powerlessness. After all, patients come to doctors for answers. A physician is an authority figure. To turn around and say I need to speak to a higher authority could be seen as a sign of weakness, ignorance, or at the very least, lack of confidence. But that strikes at the heart of the Gemara—“Tov she’berofim leGehinnom— the best of doctors are destined to go to Gehinnom [hell].” I’ve researched this Gemara and discovered its real meaning. It’s not as I originally thought, that doctors who don’t pray for their patients go to Gehinnom. Rather, it’s doctors who don’t feel a need to ask anyone else, neither other doctors nor the Creator, so confident are they in their own abilities—they are the ones who go to hell. Some commentators say that these “good” doctors either omit the refa’einu blessing—the prayer for healing—in the Shemoneh Esrei or else say it without intent.

I will never have that kind of confidence. I enjoy consulting with other doctors and attend medical conferences to keep up-to-date. There I listen to the authorities, leaders in my field. Attendees sit in rows with their laptops open, taking notes. After each series of lectures, there is an “ask the experts” session with the presenters. No one talks about God, no one mentions prayer. But I for one am thinking of him. I bet some of these other doctors, these experts, are doing the same—and I bet some of them also pray for their patients.

Every morning, when I daven, I come back to the refa’einu blessing. I recite my list: Miriam bas Esther, another few patients, a sick relative, a few friends, and then “all my patients.” In praying for my patients, I’m speaking directly to the Creator, making him a partner in my medical practice. It’s not that I don’t trust my skills as a doctor; I do, but I also know that there’s a power higher than me. I’m not one of those “good” doctors who know it all. I really need his help, and that’s why I pray.

***
Marjorie Ordene practices holistic medicine in Brooklyn.

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