Science meets spirituality
Spirituality and its connection to healthcare weren’t part of the curriculum at John Hausdorff’s medical school in the 1980s, or at most other U.S. medical schools for that matter.
But today, courses on spirituality and health are offered at almost three quarters of the schools training doctors.
Patients say they need and expect their doctors to treat the whole person, not just the disease or illness, and the schools are responding.
Dr. John Hausdorff, oncologist
and medical director of
Community Hospital's Palliative
Medicine Consult Service and
Hospice of the Central Coast
“The better we are as doctors, the more we weave spirituality not into our diagnoses but into our treatment plans,” says Hausdorff, a Monterey oncologist and medical director of Community Hospital’s Palliative Medicine Consult Service and Hospice of the Central Coast. “The question is how open and skillful can we be in exploring the patient's spiritual makeup, and in incorporating this into a mutually agreeable plan of action.”
“It’s about connecting with the person who has the disease. It’s about getting on the same page as the patient, about working together to figure out the best way to create the highest possible quality of life. Everybody is different, so it has to happen on an individual level.”
Even the definition of spirituality is different to different people, says Chris Williams, coordinator of Chaplain Services at Community Hospital. To help add clarity, Williams says, the George Washington Institute for Spirituality and Health at George Washington University School of Medicine and Health Sciences, a leader in the field, has come up with a definition that “creates a shared vocabulary and gives people ways to talk about it.”
“Their definition,” Williams continues, “is that spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose, and the way they experience their connectedness to the moment, to the self, to others, to nature, and to any profoundly significant or sacred concern.”
Some people are keenly aware of and directed by their spirituality throughout their days. For others, it is back-of-mind, until something such as illness arises to strip away the veil and compel them to search for a deeper sense of self.
The meditation room at Community Hospital offers patients and
visitors a place for quiet reflection and spiritual awareness.
“Most people have a lot of untapped spirit, until they get sick, and that’s when they get there,” Hausdorff says.
“Everything gets torn asunder, and the spirit becomes accessible. This is why, as horrible as cancer and other illnesses can be, many patients comment that in some ways it’s the best thing that ever happened to them. Spirit is the silver lining that enables them to get down to what matters most and get through this journey.”
Can tapping into spirituality make a difference in disease? Many studies show that it can have some impact, not as a cure or cure-all but in other ways.
Hausdorff cites a study in the August 2010 New England Journal of Medicine in which 151 patients newly diagnosed with metastatic lung cancer were randomly divided into two groups.
The first group received conventional medical treatment, usually involving chemotherapy and/or radiation. The second group received the same treatment plus palliative care. Palliative care is typically provided by a team that includes doctors, nurses, social workers, and clergy who deal with symptom control, pain management, and the psychosocial issues that often accompany a chronic, life-threatening disease.
“Researchers,” he says, “anticipated that the patients receiving palliative care along with conventional care would experience a measured improvement in quality of life, and that they would require less aggressive end-of-life care, such as ER visits and hospitalization, during the last two weeks of life. Both of which they did. But the surprise was that these patients also lived longer.
The average length of life for the group without palliative care was 9 months. But patients receiving palliative care lived 11.5 months. This was unexpected and very meaningful. Palliative care made a difference, not just in quality of life but in longevity.”
Rev. Chris Williams,
chaplain and coordinator
of Chaplain Services
at Community Hospital
Hausdorff also has observed that terminally ill patients who end their acute care and shift into hospice or palliative care often seem to feel significantly better. It may be that their symptoms from chemotherapy and other treatments subside. But he also believes that their spirituality is brought to the surface and they begin to focus on what matters and who matters, on resolving issues, and on finding peace.
“Patients often suffer deeply in ways both difficult to witness and hard to ease,” says Williams. “Addressing the spiritual needs of patients is respectful. Spirituality equips us to trust that strangers can help us, and to hold the people we love, to value them, to affirm how important they are. Margaret Mead said civilization began for humanity when the first femur was repaired — someone stayed with the person while others went out and foraged for food.
“Medical care is spiritual and physical; it says people are worth caring for and healing when they’re broken. Thus, a hospital is one of the most spiritual places in the world, not only for patients but for all who work here. We can’t help someone who is in crisis without having our own spiritual experience, without getting to the core of who we are, our purpose here, and what matters.”