Labels: catholic, Divine Mercy, eucharist, healing, prayers, reconcilation, Rosary

WHILE I CONTINUE to keep this Oath inviolate may it be granted to me to enjoy life and the practice of the art and science of medicine with the blessing of the Almighty and respected by my peers and society, but should I trespass and violate this Oath, may the reverse by my lot.

Know Our Subject

Our words and actions reflect who we are. Prayer is essential. We need to begin and end the day with prayer. It is the way we need to ground ourselves. We hold lives in our hands. How can we not start with prayer? It is essential to face the challenges of the day on our knees.

Humanae Vitae – Encyclical Letter of Pope Paul VI, 1968 – changed everything. “Let your conscience be your guide” no longer meant the same thing. “INFORMED” conscience – had to start actually upholding the Hippocratic Oath, follow the Magisterium - as written. So, what do you do, when modern technology, modern media, etc. is screaming to do different things?

• Don’t guess – ask questions – really find out what they want to do. Don’t judge.
• Offer as much information to the patient as possible – help guide them to as fully an informed decision as possible
• Support them as much as possible
• Even in a “crisis” situation – attempt to teach them that at “crisis” moments there can be moments of real grace possible – families can come together, support each other through things they never thought possible.
• In the end, if they insist on a procedure that you know is unethical – you may have to simply tell them “I can not in good conscience do that” – and they will have to go elsewhere. You are allowed to do this, under law.

The formation of one’s spiritual life is essential to face the tasks that come our way.

Mother Teresa

“Loneliness and the feeling of being unwanted is the most terrible poverty.”

“Being unwanted, unloved, uncared for, forgotten by everybody, I think that is a much greater hunger, a much greater poverty than the person who has nothing to eat.”

“Do not wait for leaders; do it alone, person to person.”

“Each one of them is Jesus in disguise.”

“Every time you smile at someone, it is an action of love, a gift to that person, a beautiful thing.”

“If we have no peace, it is because we have forgotten that we belong to each other.”

“In this life we cannot do great things. We can only do small things with great love.”

“Let us touch the dying, the poor, the lonely and the unwanted according to the graces we have received and let us not be ashamed or slow to do the humble work.”

“Many people mistake our work for our vocation. Our vocation is the love of Jesus.”

“Our life of poverty is as necessary as the work itself. Only in heaven will we see how much we owe to the poor for helping us to love God better because of them.”

“The biggest disease today is not leprosy or tuberculosis, but rather the feeling of being unwanted.”

“There is more hunger in the world for love and appreciation in this world than for bread.”

“We need to find God, and he cannot be found in noise and restlessness. God is the friend of silence. See how nature - trees, flowers, grass- grows in silence; see the stars, the moon and the sun, how they move in silence... We need silence to be able to touch souls.”

“We shall never know all the good that a simple smile can do.”

1. We will all die soon enough.
2. We will be in either Heaven or hell, forever. For ever. (For ever and ever and ever...)
3. Please take some time to think about "forever" if you have not already done so. Think about being somewhere for 1500 years, 40 billion years, 40 billion billion billion years... Please think seriously about this reality.
4. This mortal life is absolutely nothing compared with forever. So then, how much of ourselves should we devote to eternity?
5. All of it. Devote your entire being to getting yourself and others into Heaven.
6. Now.... DON'T WORRY!

You can heal souls. Give out Divine Mercy prayer cards. Wear the Divine Mercy pin. Patient’s will see it, and ask questions. You will become open to discussion – this is a life saving – ETERNAL LIFE SAVING – teaching. Teach them the promises of Our Lord to heal and restore their souls. Just like the image Our Lord asked Faustina to have painted, of the blood and water - pouring from His heart - blood standing for the Eucharist, "water" standing for the water of Baptism - just as this is a healing, sacramental image, this is a healing sacramental devotion, that points us towards Christ. It is also a scriptureal devotion. Just as the blood of the Lamb covered the doorways of the Israelites in Egypt, protecting them from the Angel of Wrath, Jesus' blood pours out over us, and He stands in the doorway, and His ocean of Mercy protects us, even at the moment of our death, when the Divine Justice of God should fall down on us.

Jesus said to St. Faustina: "I desire trust from My creatures. Encourage souls to place great trust in My fathomless mercy. Let the weak, sinful soul have no fear to approach Me, for even if it had more sins than there are grains of sand in the world, all would be drowned in the unmeasurable depths of My mercy. (Diary, 1059)"

http://www.stjames-church.com/notebookpreface.html
(Complete text of St. Faustina’s Diary available online)

Last week I attended a two-day conference in Worcester at Holy Cross College. I'd like to share my notes with you, each in separate postings.
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4th Annual Heathcare Professionals for Divine Mercy Conference
Medicine, Bioethics and Spirituality
April 29th & 30th 2008 – Holy Cross College, Worcester, MA

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Mark Tuttle: Catastrophic Injury: Healing in Mercy

Survivor of a catastrophic injury – lost a leg – hospitalized for months – almost didn’t survive the accident

• SUPPORT – is so important – little kindnesses – the kind that the person doing them probably barely notices – are SO important.
  
  
• People need others to care – to PRAY for them – pray by the bedside – pray as you walk the hallways – pray in your car – pray everywhere - he had people praying for him that he barely knew – and all the prayers encouraged HIM to keep praying – not only does he feel that the prayers helped him heal – they helped him hang onto hope.
  
  
• DO the things you want to do. You can’t wait for the “right time” – you never know what is going to happen tomorrow and what will come next – or if tomorrow will even come. Be ready for there to be NO tomorrow – or for tomorrow to look COMPLETELY different. DON’T go through life like a zombie, expecting every day to be the same. It won’t be.
  
  
• Just “being there” is so important. You don’t have to say anything – just sitting and “being” is so helpful
  
  
• Sharing is SO important – be human – don’t be afraid to share your faith – you have NO idea who will LOVE what you have to give – and miracles may happen in their life because of something you share with them.
  
  
• Always ask if they know about Divine Mercy – teach them if they don’t know

• Offer support – preach the Gospel at all times – when necessary, use words (St. Francis)
• Pray as you walk into the room.
• Personalize your care for each patient’s needs.
• USE the assistance of the patient’s family and friends (train them if you need to) – the patient will feel immeasurably more comfortable if even some of his care can be given by friends or family – with loving hands
• Lean on the grace of God
• Have confidence and acceptance of God’s will in the patient’s life – be calm “pray, hope, don’t worry”

Path to Holiness:

The path of the Patient – Path of the Provider: it is our job to take this work with us and become the Merciful Presence of the Lord in their lives. Offer support, offer an environment where the patient, family, and friends can pray, meditate, offer up their suffering – know God in whatever way they can. The Patient can be an incredible example of courage and grace to each of us.

We can be “living tabernacles” for our patients – bringing them Jesus every day, by everything that we do and say.

John Clark MD – Clinical Director, Center for Head and Neck Cancers, Mass General Hospital, Boston – Medical Challenges and Spiritual Considerations in the Treatment of Patients with Cancer

We are in relationships with people – but they are relationships created by illness, by sorrow, by pain. We are bonded by the stories they tell us. We are brought together – could it be by divine intervention?

CAN I BE SPIRITUAL IN MEDICINE?

• “Spiritual” needs may be small/mild/low if the medical need or treatment need is mild, minimal, or acute or reasonably simple. Offer simple reassurance, respect, hope. Live your faith – see the face of Christ in every patient.
• Spiritual needs may be quite high if treatment needs are severe, chronic, or even incurable
• Offer support, respect, hope, insight
• Be patient specific, even offer your own life experiences.
• Build patient trust in the medical system (since that’s where you are meeting them)
• Work within their faith structure – but be aware that it may be different than yours – but it’s ok to ask for respect for your own faith as well. Most will typically accept that.
• It’s a journey not a “process”
• Spiritual needs will often increase as treatment needs decrease as illness progresses – because pt morbidity increases and palliative care increases
• By the time the patient is concerned primarily with end of life issues, they will be nearly 100% concerned with supportive care issues and spiritual care issue, while medical care issues may actually be very minimally an issue for concern.
• Priority is always the patient with the illness NOT the illness itself

When surveyed, patients stated that almost 70% were “highly” religious, and of those, 89% were African American, and 79% were Hispanic; yet 72% the patients surveyed stated that their religious needs were not met at all by the medical team. Yet, studies found that those who utilized some form of religion or spirituality in their life and in their care had a higher quality of life, overall.

Providers must:

• seek opportunities to identify and support spiritual needs
• enhance quality of life, healing, and wholeness
• respect patient boundaries and autonomy
• provider patience and understanding will facilitate proper decision making when time is right
  

Patient’s fear things

• fear is universal
• Hopelessness and depression regarding illnesses, misfortune are common
• If we are not ill, we know someone who is
• We fear loss – loss of independence, work, finances, life
• We fear isolation – from family, friends, community
• We fear dependency – on family, friends, or paid care providers
• We fear that the treatment might not work

We tend not to see that Crisis can be linked to Opportunity

Crisis can often give us a chance to redefine our priorities – but we seldom see this. We are too fearful, anxious, worried about what tomorrow will bring. We set the limits and the boundaries, based on all the fears our imagination can stir up – and we can’t conceive that there might be any blessings inside the clouds we see blocking our way.

We want what we want – and if we can’t have it – it’s a –disaster. Yet – sometimes we are forced to slow down – and in this forced interim, we can redefine our life’s priorities, our marriages priorities, our parenting priorities, sometimes dysfunction from gambling and addiction ends, or we reach out to others from whom we have been estranged. We have a choice. We need to focus – we need to contemplate. Suffering can have meaning.

Spirituality in Medicine

After the rise of Science – via Copernicus and Darwin – spirituality was equated with “superstition” in the minds of many. A view of the universe as created was rejected. The world was “random” and “chaotic” – the scientist who said otherwise was ridiculed - and the training of any sort of spiritual skills in the medical practitioner was left to chance or the choice of the individual practitioner. This despite the research of Gregor Mendal, the Catholic monk who was the pioneer of genetic science, and Georges Lemaitre, Catholic priest and “father” of what came to be called “the Big Bang Theory” of the origins of the universe.

- Francis S. Collins, M.D., Ph.D., is a physician-geneticist and the Director of the National Human Genome Research Institute, NIH – a man who cannot be called anything but a serious scientist – who wrote - "The Language of God: A Scientist Presents Evidence for Belief” in 2006 - and stated - "DNA sequence alone, even if accompanied by a vast trove of data on biological function, will never explain certain special human attributes, such as the knowledge of the Moral Law and the universal search for God." He further insists that "science is not threatened by God; it is enhanced" and "God is most certainly not threatened by science; He made it all possible."

Other respected scientists have written numerous books regarding the junction of science and faith, including:

- Dr. Kenneth Miller - Professor of Biology, Brown University; "Finding Darwin's God: A Scientist's Search for Common Ground Between God and Evolution" - a lively and cutting-edge analysis of the key issues that seem to divide science and religion. He contends that, properly understood, evolution adds depth and meaning not only to a strictly scientific view of the world, but also to a spiritual one. Miller is a firm believer in evolution, he is one of America's foremost experts on the subject, but he also believes in God—and he doesn't think the two beliefs to be mutually exclusive.

- Michael Ruse is a Professor of Philosophy and Director of the Program in the History and Philosophy of Science, Florida State University. He is the founder and editor of the journal Biology and Philosophy, and has appeared on "Quirks and Quarks" and the Discovery Channel - "Darwin and Design - Does Evolution Have a Purpose?" (Toronto Globe and Mail Best Book of the Year) In clear, non-technical language Michael Ruse, a well-known authority on the history and philosophy of Darwinism, offers a full and fair assessment of the status of the argument from design in light of both the advances of modern evolutionary biology and the thinking of today's philosophers--with special attention given to the supporters and critics of "intelligent design."

- Darrel R. Falk is professor of biology at Point Loma Nazarene University in Point Loma, California. He is also the director of the Howard Hughes Medical Institute outreach program. His research interests have included molecular genetics of Drosophila melanogaster, organization of genes; mechanism of repair of chromosome breaks and molecular changes in the Notch gene in various species of Drosophila; and the use of gene cloning technology to characterize damaged chromosomes at the molecular level and PCR and DNA sequencing to compare homologous gene sequences in different species of Drosophila. He has also authored a book on the creation-evolution controversy titled “Coming to Peace with Science: Bridging the Worlds Between Faith and Biology” (2004) – in which he shows how an original and ongoing interaction of God with creation is fully reconcilable with the kinds of development identified by current biological science.

When searching for the answer to the question can I be spiritual in medicine?

• The answer will always be personal
• Spirituality may pre-exist training
• Can develop during clinical practice
• Emphasis in recent training modalities is typically only addressed in addictions programs.
• Any other mention is usually “in passing”
• Most recently (past couple of years since new Joint Commission standards especially)worked directly into medical education – quite often however, medical students may complete a “psych rotation”, with a “spirituality component” and have all the right answers on an exam – but be no better prepared in real, daily practice. They can take spiritual histories - Define spiritual “needs” - but they fall down in actual patient care
• Also recently - Various larger hospitals have formed "Teams" - Could run the risk of forming specific “palliative care teams” where the “job” of spiritual care advisor is farmed out to a consultant or specialist

Spiritual challenges of a patient

• Will it solve everything? NO! It’s a support!!!
• Will it help, or will it hurt? Spirituality is recognized by many studies as beneficial
• A patient asks - "Will my spiritual needs be met even if I have no specific religion?" Yes! Of course!

We wear “multiple hats” every day. Medical/clinical – treatment provider/pharmacist – spiritual counselor/rabbi/priest/deacon/nun – we need to be aware of medical and treatment issues, medication issues, and worship/spiritual issues – we should not become “practicing specialists” – don’t hand off the patient to the specialist, consultant, next treatment team on the list – LISTEN, CARE, DO – and have mercy – open your heart –

We must be like the disciples who went out into the world where they were called, and met the people where they were, and did what needed to be done. St. Paul walked the dusty roads, teaching Timothy and John Mark, patching tents for a living, and sharing the Good News. He converted his jailors from prison, and rejoiced a the thorn in his own side, joining his own suffering with that of Christ crucified. He was “all things to all men” – we must also do this.

Wear as many “hats” as you can….

- Goals -
Prevent pain and other symptoms; Support patient emotional well-being; Support family and other caregivers; Continuity of care, advanced directives; Respect, well-being; Spiritual issues addressed respectfully; Psycho-social issues; Decide - Hospice or palliative care; Peace; Integrity; Dignity; Hope; Pain and symptom management; Knowledge;Empowerment (patient)

- Skills -
Listening; Communicating effectively; Culturally appropriate; Knowlegable about not just medical needs, but also available community resources, etc.; Emotional support; Anticipating needs; Just “being there”

- Patients Want -
Information; Hope; Social supports; Ability to make decisions; Dignity; Respect; Pain management; Family input (Input from significant others, friends, members of their religious community, etc.); Their own input; Ability to make final preparations

Pain is a huge issue for many chronically ill / terminally ill patients. In 88% of cases it is poorly managed – often other concerns such as secondary side-effects or concerns regarding drug abuse are factors. What is not considered is how the patient actually feels.

Non-pharmacological pain relief methods: heat/cold, relaxation, positioning/repositioning, music, distraction, imagery, massage, humor.

Medications: Non-steroidal; Opiates; Biphosphonates; Radiopharmaceuticals; Radiation Therapy

Fatigue – “tiredness” is not fatigue – tiredness is transitory and is relieved with rest. Fatigue is pervaisive and is unrelieved by even extensive rest. Often associated with stress – such as chronic illness/terminal illness. Validate patient’s feelings. Correct underlying physical causes, if possible. Balance meds that might be causing symptoms – such as meds causing side effects of drowsiness, breathing difficulties, etc. Reduce stressors. Consider anti-depressants (beware of side effects, consider time to take effect)

What is “spirituality” and how does spirituality play into chronic/terminal illness?

• No absolute definition – many cultural and religious definitions
• Brings meaning and a sense of “wholeness” to a person
• Deep, often religious feelings and beliefs – often quite strongly held
• Spiritual care providers can be family, friends, chaplain, clergy, social worker, case manager, outreach worker, even pets – can be any person involved in the person’s care
  

Studies consistently show, over and over, that patients state that faith is a significant factor in their care

• It is essential to treat the patient as a whole person
• It helps provide a framework to the patient to help the fine “meaning” for what they are going through
• Helps them find control over their feelings of anxiety, fear, and helplessness
• Gives them hope and comfort
• Is an effective coping mechanism

Why are faith issues often omitted from care and treatment planning?

• Lack of education on the part of care providers
• lack of expertise
• too challenging
• seen as too individual, too personal, “too intrusive”
• seen as too time consuming

Labels: catholic, Divine Mercy, eucharist, healing, reconcilation