Tears and touching are some of the most profound forms of connection among people. They soften hearts and open doors to each other’s hearts that were otherwise closed. Spiritual care in a hospital environment brings people together in the best way possible under the worst of conditions. I regularly meet strangers and confront situations that require patience and acceptance so I can do the best for others.

What does a multi-faith hospital chaplain do? First and foremost, a chaplain is always there to be a listening ear in a compassionate and caring manner. A hospital chaplain cares about spiritual and emotional well-being of patients, their families or loved ones, as well as the staff at the hospital. As chaplains, we are in the service of everyone, religious or non-religious, faithful, agnostic, or atheist, during both good times and bad times to share joy and sorrow. We visit the patients that need comfort and support, and listens to their worries, concerns or happiness. We are with the patient in their last moments to offer blessings and stay with the families when their loved ones are going through this transition. We are together the broken-hearted who need to be heard, patients who request prayers before their surgeries, and babies who are newly born or die young. We touch hearts, wipe tears, listen to life stories, open spiritual gates, and help people reflect on their own lives to find out where they are on their journey. Lastly, we encourage and empower the ones who are in their recoveries. Sometimes patients are the teachers who allow chaplains journey with them.

I had an interesting encounter with a 67-year-old Catholic lady who came to the hospital for spinal surgery. She did not ask for a chaplain visit but her name was on my unit list. I met her post-procedure during my regular rounds. She was frustrated and upset because the doctors told her that she had cancer; however, what type of cancer she had was still unknown ten days into her stay. She was emotionally overwhelmed with worry about her physical condition because the doctors were still testing the results, and she felt they were not giving her clear answers. She was not alone, because her daughters lived close to her however she could not help but cry when she started to speak about being away from her home and family for a long time, along with the uncertainty she faced which was obviously hindering her ability to cope. I was very concerned with her psychological and emotional state. She was not ready for a longer conversation with me. She dismissed me after a few more minutes and said, “I rather want to be alone at this moment”. I replied, “I understand, it is okay with me.” Upon leaving, I reflected on not being able to help her at all. I felt badly of the situation, and felt that I had missed an opportunity to provide care that I was not able to reach through to her.

The next day, the patient’s nurse telephoned the Spiritual Care Office and requested that I return. The phone call meant a lot for me because I anticipated that there was something significant happening. I immediately went to the patient’s floor and saw her nurse. She told me that the patient wanted to see me before she was transferred to another unit. Upon entering the room, the lady told me that she did not want me to know her as a rude person. She apologized for her attitude the other day and said, “We are both believers and we should not be like that towards each other.” I confirmed this sentiment, and she continued, “I don’t know as much about your faith as I should know, and I felt that I need to know more of it.” She asked me if I could talk about the main principles of Islam, and I accepted her request. I stayed with her explaining, shortly, the basics of Islam, how God sent prophets to all human beings throughout history, and how the Qur’an was revealed and compiled. We had a good discussion which relaxed her and as our conversation ended our relationship between each other was more important than her illness. Her embarrassment replaced with peace at the end. “I am so glad that I was able to call you back,” she said with contentment. “I am so glad that you took the opportunity to invite me again to your room” I responded with a smile. This time, I left her room with a great sense of relief and satisfaction.

“Can you hold my hand?”

Another thought-provoking visit was with a 69-year-old lady who came to the Emergency Department (ED) on a night when I was on overnight duty. It was 4:40 am when I was paged by the ED nurse as the patient asked for a Catholic priest, who was not available. She indicated that the multi-faith chaplain was okay to visit with her. She looked youthful and pretty in her bed but, as I asked her about her concern, she responded, “I am scared of dying.” Doctors had told her that she had an obstruction which was resulting in a removal of one of her kidneys. She was also experiencing blood pressure and diabetic issues.

She was alone at the hospital and her emotions were in a whirl with many thoughts on her mind as the surgery was imminent. We continued the conversation in a manner to address the frustration and fear she was feeling. She responded positively to my empathy and reassurance. She told me about her financial difficulties and that she would lose her home soon. Then she asked me, “Can you do me a favor?” I said, “Sure, what is it?” She asked, “Can you hold my hand?” I took her hand gently and prayed to God, asking Him to provide her with comfort, peace, relief from her worries and for a successful surgery. It was a moment that we both appreciated. After prayer, she asked me about myself and we spoke of our families. I reminded her that the Spiritual Care would be happy to be with her and that I would like to follow up with her during her stay. She seemed relieved and less anxious by the time I departed. I can only imagine how stressful it was for a lonely lady who was dealing with many issues in a strange place in the middle of the night.

From a personal point of view, conversations on faith or religion always remain behind the feelings or emotions of the patients during my visits. I focus on their current spiritual or emotional crisis within the hospital. My goal in my interactions with patients is to provide a safe and non-judgmental space built upon trust and a genuine human connection. After assessing their needs, sometimes I explore if they have a religious background or community, any spiritual practices such as reading holy texts, prayers, rituals, or meditations which might be helpful support for them. I also try to understand if any of their practices help them cope with their difficulties in any way. On the other hand, each patient is unique and each visit is different than the last. One common point is that when words cease to be enough, a warm touch on the hand or the shoulder, or a silent tear shed, become powerful enough to build the connection between the chaplain and the patient. The goal is to always share a genuine moment between two strangers, one of which may literally be on their death bed. It helps to remind us that our faith and appreciation of the Divine can unite us, and that we will all return to God someday.

East and West. Maybe it is not easy to draw straight lines where these two are clearly separated, and yet everyone has a conceptualization of what is meant when this distinction is proposed. While some circles try to delineate the differences and polarize societies on the basis of “us vs. them,” there are others who prefer to highlight commonalities, shared pains and joys, the benefits of interaction, and an inevitable future of less separation and more coexistence.

One dynamic of our shared society that will shape such a future is migration. Migration is a reality of the human condition. Throughout history, migrations, be they mass or individual movements, have not only shaped our societies, national borders, languages, religious traditions, and of course, identities, but have also been a major catalyst for disputes and conflicts. Hence, for the last several years, the US has been debating whether a wall should be built across the Mexican border; we continue to watch the heart-breaking tragedy of thousands of refugees rowing across the Mediterranean; the ongoing plight of Syrians fleeing their country’s violence; and more recently, the forced migration of teachers, doctors, and civil servants affiliated with the Hizmet Movement from Turkey, their homeland, where they have suffered persecution for the last few years. Due to many reasons, including geographical, historical, and colonial ties, Europe has been one of the major destinations for those seeking freedom and a life of security, especially for many Muslims. Akbar Ahmed’s book Journey into Europe: Islam, Immigration and Identity (2018) is one of the most comprehensive researches into this very complex social phenomenon. In this issue, Behzad Fatmi from India reviews Ahmed’s book and explains how the author dissects the fundamental character of European society vis-à-vis the place of Muslim communities in the continent.

Learning theoretically about diseases is surely important. But having a first-hand experience, or at least spending time with those who suffer from a disease, teaches much more than what one can learn from books. Ceyda Sablak shares her experience with some patients who told what they have been through with Amyotrophic Lateral Sclerosis (ALS). She writes how important it is to have an accurate and concrete diagnosis, even if it turns out to be a terminal illness. While it is painful to go through such an illness, it is no less of a burden on the shoulders of doctors and the family who have to be present next to their loved ones and do as much as they can to continue to care for them.

The problem of pulmonary tuberculosis in pregnancy has attracted the attention of doctors for many years and it is still a current issue. Modern researchers and physicians divide tuberculosis into several independent problems which have difficult solutions. On the one hand, there is the influence of tuberculosis on the course of pregnancy and child delivery as well as on the health of a mother and her child. On the other hand, there is the influence of pregnancy and childbirth, the puerperal period and lactation on the course and progress of tuberculosis.

Research on how pregnancy influences the course of tuberculosis has been carried out for many years. Even in the oldest available documents we can find instructions for “personal precautions” and preventative measures against tuberculosis, as well as thoughts about pregnancy and tuberculosis. In 1400 BC the Law of Manu from ancient India prohibited marriages to girls from families with tuberculosis. In different world religions, including Islam and Christianity, there are special restrictions concerning people who suffer from this illness.

In ancient times Hippocrates and Galen taught that pregnancy has a positive influence on the function of lungs. But the Islamic doctors, Arabian as well as Spanish, of the Cordoba Caliphate considered that the blessed process of pregnancy must not be complicated by pulmonary diseases.

With time European medical science changed its point of view. From the second part of the 17th century until the beginning of the 19th century doctors considered that pregnancy had a bad effect on the course of tuberculosis, but then the situation, for some reason, changed. Doctors began to think that pregnancy had a good influence on lung diseases. They even started to advise girls who were susceptible to tuberculosis to marry. Time passed and doctors began to change their opinion on tuberculosis in pregnancy and the extremes in views became less obvious. This happened due to the introduction of an artificial pneumothorax into the treatment of tuberculosis.

Since then the third period in the understanding of the relationship between pregnancy and tuberculosis has begun. The opinion about the course of tuberculosis in pregnant women has changed due to the successful therapy of tuberculosis with the help of the artificial pneumothorax.

During the gestation period, all the organs and tissues of the entire organism experience an increased load, as they are trying to satisfy both their own needs and that of the developing fetus. These morphological and functional changes do not lead to any pathological state in the mother if she is healthy and her course of pregnancy is normal. If the woman’s organism has been weakened by a chronic immunodeficiency due to poor environmental conditions or if she has a tuberculosis process in her organism, then functional changes and tissue dystrophies can develop in her nervous system which will lead to metabolic disorders. Changes in ergasia caused by pregnancy and connected with changes in higher nervous activity, as well as with endocrine reorganization, can influence the development and the course of the tubercular process.

Before penicillin was discovered, pregnancy usually led to the progression of the disease and in many cases even ended fatally. Nowadays due to the use of effective antituberculous medicines the attitude towards possible pregnancy of women who have active tuberculosis has considerably changed.

Tuberculosis in a pregnant woman usually starts in an acute form; at this stage infiltrative forms of the disease with necrogenic and bacterioexcretion prevail, often combined with exudative pleurisy, trachea, larynx and bronchi lesions.

Frequent consecutive pregnancies have a negative effect on the state of women who suffer from tuberculosis; they weaken the organism and can cause the recrudescence of the tuberculosis process. This is very typical of many families in poor Asian and African countries. More than half of all pregnant women suffering from an active form of tuberculosis experience a progressive iron deficiency anemia during the first three months of pregnancy and in the second trimester of pregnancy this can be observed in almost all patients. Malaria is also widespread in Asian and African countries that are situated to the south of Sahara and are the second reason for iron deficiency anemia.

According to modern views, one of the reasons for the recrudescence of the tubercular process during pregnancy is an irregular or non-systematic treatment of this illness or the absence of any treatment at all. The recrudescence of the process observed in those suffering from destructive pulmonary tuberculosis is caused by the severity of the illness itself when new conditions for the organism occur. In this case, pregnancy begins against the background of an advanced chronic immune deficiency. At the same time, due to the feto-placental complex operation, functional changes in the nervous, respiratory, cardiovascular and urinary systems, as well as hormonal changes, in the organism of a pregnant woman take place.

Moreover, the development of the fetal skeleton requires calcium which is absorbed not only via the blood of the mother, but also from the healed niduses of tuberculosis and as a result, the progression of a specific process can appear.

The reactivation of the tubercular process happens due to a decrease in the responsiveness of the organism and because of an increase in the activity of the reproductive hormones and the loosening of the connective tissues which are physiologically involved in pregnancy. The amount of plasma and extra vascular fluid increases. Due to these changes, a swelling and loosening in the inactive tubercular niduses with the mycobacteria of tuberculosis can appear. And loosening, in its turn, enables a lymphohematogenous spread of mycobacteria.

In addition to these, the delivery of a child leads to a speedy reorganization of all the functions of the organism; lactation and nursing in their turn are combined with an increased loss daily of nutritious matters and a large amount of protein and fats. In case of destructive pulmonary tuberculosis, due to the fact that the diaphragm descends (resulting in the abdominal decompression ceasing to have a therapeutic action of pneumoperitoneum) bronchogenic dissemination appears in the unaffected parts of the lungs.

A specific active process can be observed in women belonging to the high-risk group in connection with tuberculosis. The high-risk group combines women who have recently suffered from tuberculosis (less than one year after treatment), those who have just been operated on for a tuberculosis connected illness (less than one year), women with tuberculosis of different localizations younger than 20 years (for Asia and Africa) and those older than 35 years (for Europe and the USA), those with widespread forms of the tubercular process withstanding its stage, women who have had contact with people discharging bacteria or people suffering from tuberculosis but not discharging bacteria, and also those who have coexisting illnesses (diabetes, chronic nonspecific pulmonary illnesses, problems with kidneys, stomach and duodenum ulcer), and also women who use alcohol, narcotics, those who smoke and lead asocial ways of life. In these cases, the women must be properly examined during the gestation period, including X-rays.

Treatment of tuberculosis during pregnancy

All other conditions being equal, the timely detection of active tuberculosis during pregnancy allows doctors to provide a full course of treatment, allowing the woman to recover and give birth to a healthy child. Untreated active tuberculosis of the mother is much more dangerous for the fetus than anti-tuberculosis chemotherapy.

Special attention must be paid to healthy women who are in contact with bacillary patients. Quite often these women might undergo active tuberculosis for the first time during pregnancy or after the delivery itself.

In the pre-penicillin era the recrudescence of the tubercular process during pregnancy and after the delivery proceeded in an acute form with frank infiltrative changes, a necrogenic process, bloody expectoration and very often a generalization of the process. Nowadays, the clinical outlook for complications and the recrudescence of tuberculosis against the background of pregnancy is less gloomy. It more resembles the toxicosis of pregnancy or respiratory diseases.

While examining a patient, special attention must be paid to chest problems like moist or dry coughs, bloody expectoration, pain in the chest and shortness of breath. If the patient coughs with expectoration for 2 weeks then she must be examined for mycobacteria with the usage of a microscopic technique.

Another syndrome, which is also very important, is a complex of intoxication symptoms (weakness, hidrosis, anorexia, weight loss, long-lasting low grade fever and hyperirritability) which need to be detected to discover the reason for their development. While examining the anamnesis of a pregnant woman it is necessary to learn if she has ever suffered from tuberculosis before, if she has had any possible contacts with infected people, whether there are cases of tuberculosis or concomitant diseases in her family as all of these can be very useful for the verification of tuberculosis.

When active pulmonary tuberculosis is suspected an X-ray examination is necessary. When the chest is in frontal projection, the X-ray exposure of the fetus is 10 times lower than that of its mother (with compulsory use of a protective apron). Examination of the cough expectoration for the presence of tubercular mycobacteria is one of the easiest, most effective and informative diagnostic methods.

Chemotherapy, which destroys the tubercle bacillus that spread in the organism, plays a leading role in the variety of methods for tuberculosis treatment. By reducing the population of bacteria, chemotherapy supports the healing process, the dispersion of inflammatory changes, the closing of caverns, the encapsulation of the remaining loci as well as preventing the development of sclerosis. When the patient suffers from tuberculosis, the healing processes are very slow; the first stage of the recovery process of mycobacteria ceases and only after some months, in the case of a successful treatment of tuberculosis, does the healing process finish.

The necessary treatment of pregnant women who suffer from tuberculosis must start as soon as the diagnosis has been made. Chemotherapy implies taking antibacterial medicines (isoniaside, rifampicin, pyrazinamide, ethambutol, ethionamide and etc.) in different combinations. The choice of this or that combination depends on the stage of the disease as well as on any undesirable reactions to the medicines prescribed.

The treatment of tuberculosis (if there are indications) continues during the entire pregnancy and lactation period. In particular, patients with tuberculosis that has been diagnosed during the pregnancy are in need of treatment. When there is a systematic treatment, up to the moment of delivery and in the puerperal period, positive clinicoradiologic dynamics can be observed regarding the specific inflammation (stoppage of bacterioexcretion, closing of caverns, dispersion of loci, infiltration and exudate). Patients who reject treatment during the process of pregnancy suffer from an advancement of the illness.

Transplacental infection of the fetus with tuberculosis almost never occurs, but the baby can be infected from the mother in the puerperal period. There is also a possibility of contamination during delivery, but this is a rare occurrence.. God truly protects the innocent!

Permission to breast feed must be given by a joint resolution of an obstetrician, a pediatrician, and a specialist of tuberculosis taking into account the state of a woman and the form and the stage of the tubercular process. Overall precautionary measures must be taken (a nonbacterial mask of 5-6 layers covering the nose and the mouth, a kerchief covering the head and thoroughly washed hands).

A bacteriological study of the breast milk of women who suffer from tuberculosis shows that typical mycobacteria rarely vegetates (no more than 0.33%). Human milk has the ability to suppress the development of the mycobacteria of tuberculosis. This must be connected with the rich spectrum of ferments, immunoglobulins, cellular elements, macro-phages, the complement system, interferon and other factors of nonspecific protection which human milk contains.

The contraindications for nursing are as follows: tuberculosis of the lactiferous gland, an acute form of tuberculosis, active pulmonary tuberculosis with bacterioexcretion, active tuberculosis of any organs detected at the end of the pregnancy or after the delivery, and recrudescence of tuberculosis during the pregnancy. Children born to such mothers are immediately isolated after their birth and bottle fed, they are vaccinated and stay in the hospital for 6 weeks if possible (the minimum period for compulsory postvaccinal isolation).

Thus the tubercular process in the lungs, especially an active one, will have a negative influence on pregnancy and delivery. Babies born to such mothers belong to a high-risk group as far as the possibility of neonatal pathology and antenatal death of the fetus are regarded. Women with pulmonary tuberculosis must undergo regular consultations with both an obstetrician-gynecologist and a phthisiologist from the very early stages of their pregnancy. They must also receive special treatment until all the signs of active tuberculosis have been eliminated.

But this has started to change. Increasingly, professionals from respected institutions are conducting scientific studies of the effects of faith in healing. Recent conferences at Harvard, the Mayo Clinic, and the American Association for the Advancement of Science (AAAS) signal this change, as does major media coverage on PBS, NBC Nightly News, CNN, and CBS This Morning. Below we give examples of such scientific studies, the people behind them, and their findings.

Dr. Herbert Benson

Dr. Herbert Benson is an associate professor of medicine at Harvard Medical School and the founding president of the Mind/Body Medical Institute at Boston’s Deaconess Hospital. As the author of 150 scientific papers and six books, Benson has made important contributions to our understanding of the physiology involved in the healing effects of faith.(1)

As a young cardiologist working with people suffering from high blood pressure, Benson noticed that their blood pressure was the highest during office visits. He reached this conclusion after noticing that after treating his patients with anti-hypertensive medicines to lower their blood pressure, they would report such symptoms as fainting. This indicated that the adjusted blood pressure was generally too low. Since doses were set according to measurements made during the visit, the calibration was correct. He concluded that their blood pressure should have been lower before or after the visit.

To establish a model for stress-induced hypertension, he stopped his routine in cardiology and returned to physiology research at Harvard Medical School. Once when he was studying monkeys, about 15 young people involved with Transcendental Meditation asked him to study their responses to stress. Electrodes were attached to their chests and scalps to measure their heart waves and brain waves. Masks collected their breath as they exhaled, so their metabolism and rate of breathing could be measured. Then baseline measurements were taken while they sat quietly for 20 minutes. The same measurements were taken again while they meditated for 20 minutes, and then one last time while they sat quietly without meditating. The individuals had a 17 percent decrease in their metabolism during meditation, and a 20 percent drop in their rate of breathing. Also the frequencies of brain waves were lowered.

Benson identified two basic components of Transcendental Meditation: meditation and prayers involving the repetition of a word, sound, or movement with the out-breath; and passively setting aside other thoughts when they come to mind and returning to the repetition.

When he studied various religions and cultures, he found these essential elements in virtually every one of them. The earliest account was in Hinduism, where there were accounts of individuals focusing on their breathing and repeating a phrase of scripture while disregarding every-day thoughts. The pattern was found in Judaism, Christianity, Islam, Shintoism, Taoism, and Confucianism. He posited that this practice may be conducive to improved health perhaps by reducing parasympathetic nervous system responses to stress, known as the “fight or flight response”.*

Benson sees his work not as alternative medicine but rather as one leg of a three-legged stool. In his words: “One leg is pharmaceuticals, another leg is surgery and other procedures, and the third is self-care. That last leg includes nutrition, exercise, and the relaxation response. It’s vital not to neglect the last leg, because 60 to 90 percent of visits to doctors are for conditions related to stress, where employing pharmaceuticals and surgery is not effective.” (2)

Benson also found out that as much as faith inspires prayer, this form of prayer or meditation inspires health. He and his colleagues treated such conditions as hypertension and cardiac arrhythmia with the relaxation response, the common ingredient in his self-care program and prayer/meditation practices. They cured 75 percent of insomniacs, treated symptoms of depression in people with AIDS and cancer, and relieved nausea and vomiting related to chemotherapy. In a fertility program for infertile women that emphasizes self-care through relaxation response techniques, proper nutrition, and re-framing thinking patterns, 34 percent become pregnant in contrast to 15 percent in other programs.

Dr. David Larson

Psychiatrist David Larson is the president of the National Institute of Healthcare Research and author of the teaching workbook, The Forgotten Factor (co-authored with his wife Susan). In this book, he discusses the relationship between religion and health. Numbers supporting his work come from Gallup polls showing that 95 percent of Americans believe in God, and that although half believe in Hell, 80 percent sanguinely trust in a forgiving God. In addition, 40 percent of Americans attend worship services weekly.

During his psychiatric residency at Duke University, Larson asked a professor for some guidance on how to bring his faith into psychiatric practice. The response was: “Are you the type person who wants people to believe like you do?” Although he said he was not, the professor continued: “It is obvious you are going to hurt your patients.” He recalls that anyone who would bring up that subject would be quickly labeled as a fundamentalist.(3) But his later research and extensive publications have brought attention, which helped fund the National Institute for Healthcare Research. The Faith in Medicine program, which the institution funds, gives $10,000 grants to medical schools for courses on religion and health. Johns Hopkins and George Washington University are among the eleven schools that have received the grants.

Dr. Harold Koenig

Among the pioneers of the study of faith’s healing potential is Harold Koenig, an associate professor of psychiatry and director of the Center for the Study of Religion, Spirituality, and Health at Duke University Medical Center. Koenig first noticed the significance of faith as a factor in medical recovery when he was a young family doctor. He was consulted about a patient who had been hospitalized for a month after hip surgery. Her husband had died of a sudden stroke, and she had slipped on ice at his funeral and fractured her hip. The surgeon warned him that she was emotionally vulnerable. Indeed, she had experienced events that normally would trigger clinical depression and thus undermine her recovery.

He was therefore surprised to find the old lady cheerful when he entered her room. She said: “What can I do for you, Doctor?” Koenig’s search for obvious signs of depression-fatigue, darkened or tear-reddened eyes, difficulty concentrating-indicated nothing. Upon further conversation, he discovered that she maintained her cheerful mood by reading the Bible. She told him: “If I wake up alone or afraid, I read my Bible or talk to God. He is always there, even when my loved ones are not. It’s the most important thing that keeps me going.”

Koenig was impressed. When she recovered with few complications, he felt compelled to study further the medical significance of such deep faith. Since that event, numerous patients have told him how their faith helped them cope, thus speeding their physical healing. His research team, which has studied thousands of Americans since 1984, has compiled powerful evidence that religious faith not only promotes overall good health, but also helps patients recover from serious illness.(4)

“By praying to God, patients acquire an indirect form of control over their illness.” They believe they are not alone in their struggle, and that God is personally interested in them. This safeguards them against the psychological isolation that batters so many seriously ill people. In a study of 455 elderly hospital patients, Koenig found that people who attended church more than once a week averaged about four days in the hospital. People who never or rarely attended church spent about ten to twelve days of hospitalization.

Dr. Dale Matthews

Dale Matthews is an associate professor of medicine at Georgetown University Medical Center, Washington, DC. As a young internist in the early 1980s, he met a patient with strong faith who would make a lasting impact on his life. The man said: “I am a devout Christian. If you’re going to be my doctor, I want you to pray with me” before allowing Matthews to treat him. Matthews had never shared his own faith with his patients, so at first he was reluctant. But nevertheless he joined hands with the man, who he hoped would keep quiet and keep the matter secret. After all, he did not want to be labeled “unscientific.” He was alarmed when the man’s booming voice filled the examination room. But Matthews had a crucial realization that day: His patient was a whole person, not a composite of symptoms and tests forming a “case.” This led him to become sensitive to signals indicating that religion is important to a patient. If someone says: “I hope from God that nothing bad shows up in these tests,” Matthews will say: “Tell me your thoughts about God.” He declares: “We cannot prove scientifically that God heals, but I believe we can prove that belief in God has a beneficial effect.” In his recently published book The Faith Factor, he incorporates religious wisdom, scientific research, and patients’ stories to make a case for the faith-health connection.(5)

Statistical Findings

Health care institutions are beginning to pay attention to the faith-health connection. Harvard Medical School, the Mayo Clinic, and the AAAS have sponsored conferences on spirituality and health. Nearly half of all American medical schools now offer courses on the topic. Below we give findings of some published studies on the topic.

• In a survey of 269 doctors at the 1996 meeting of the American Academy of Family Physicians, 99 percent said they thought religious beliefs could contribute to healing. When asked about their personal experiences, 63 percent of doctors said God intervened to improve their own medical conditions. Their patients agree even more enthusiastically that prayer is a powerful tool in healing. Polls by Time/CNN and USA Weekend show that about 80 percent of Americans believe spiritual faith or prayer can help people recover from illness or injury, and more than 60 percent think doctors should talk to patients about faith and even pray with those who request it.

• According to researchers at Columbia University, children whose religiously committed mothers are less likely to suffer from depression later in life.(6) In their study, 60 mothers and 151 children were followed over 10 years to determine if there was any relationship between a mother’s religious commitment and resulting depression in her children. The study found that daughters, but not sons, of women who considered religion to be highly important were 60 percent less likely to have a major depressive disorder at the 10-year followup. A second important factor linked with less depression was the degree to which the children embraced their mother’s religion. When the mother and child were members of the same religious denomination at the followup, daughters were 71 percent less likely to suffer from a major depressive disorder while sons were 84 percent less likely.

• Another significant finding of the study was that highly religious mothers were less likely to be depressed themselves.(7) Women for whom religion was highly important were 81 percent less likely to have major depression at the 10-year followup. This finding is consistent with other studies showing an inverse relationship between religiosity and depression. Several possible explanations exist for these findings. According to the researchers, highly religious mothers also were less likely to be divorced or exhibit poor social functioning—-both of which could contribute to depression in children. Another potential explanation comes from a recent study at the Medical College of Virginia, which found that religion can protect people from depression by buffering them against stressful life events.(8)

• A Dartmouth Medical School study found that heart patients were 14 times more likely to die following surgery if they did not participate in group activities and did not find comfort in religion. Within six months of surgery 21 patients died, but there were no deaths among 37 people who said they were “deeply religious.”

• A Yale University study of 2,812 elderly people found that those who never or rarely attended church had nearly twice the stroke rate of weekly church-goers.

• A survey of 5,286 Californians found that church members have lower death rates than nonmembers—regardless of such risk factors as smoking, drinking, obesity, and inactivity.

• Those with a religious commitment had fewer symptoms or had better health outcomes in seven out of eight cancer studies, four out of five blood pressure studies, four out of six heart disease studies, and four out of five general health studies. According to one research analysis, people with a strong religious commitment seem to be less prone to depression, suicide, alcoholism, and other addictions.

• Can others’ prayers help? In a 1988 study by cardiologists Randolph Byrd, 393 heart patients in San Francisco General Hospital Medical center were divided into two groups. One was prayed for by people around the country; the other did not receive any prayers from study participants. Patients did not know to which group they belonged. The group that was prayed for experienced fewer complications, fewer cases of pneumonia, fewer cardiac arrests, less congestive heart failure, and needed fewer antibiotics.(9)

• Researchers studying a sample population of 2,730 drawn from the Alameda County Study—a long-term research project of health and mortality—found that people who both attend religious services and participate in other activities through their place of worship receive protection from the stress of financial burdens, health issues, and other problems.

• In a study of nearly 600 severely ill hospital patients aged 55 and older, researchers measured 47 ways of coping. They discovered that patients who sought a connection with a benevolent God as well as support from clergy and church members were less depressed and rated their quality of life as higher, even after taking into account the severity of their diagnosis. Researchers also found that patients who gave spiritual support to others by praying for them or encouraging their faith also faired better emotionally.

• Another recent study conducted at Duke University revealed more striking results. In the first study to examine the role of religion in recovering from depression, researchers followed 87 patients aged 60 or older who were diagnosed with depressive disorder after being admitted to the hospital for a physical illness. They discovered that religion can help people recover from depression. In fact, the more spiritual the patient, the more quickly he or she recovered.(10)

Conclusion

Can faith really heal? According to some researchers, the answer is a definite yes. The study of the link between religious faith and physical healing is very young. But there are important signs that faith can have significant positive impact on health, complementing such conventional medical practices as pharmaceuticals and surgery. Increasingly, professionals from respected institutions are looking into the relationship of faith and healing via scientific methods. Once considered a taboo, studying the healing powers of faith is now taken seriously in scientific circles. Regardless of its results, the very existence of this effort promises to expand the possibilities of cooperation between science and faith, and lead to a better understanding of human nature. *Fight or Flight Response: Stress has been defined as the perception of threat or danger that requires behavioral change. Stress results in various bodily changes, including increased metabolism, and increases in heart rate, blood pressure, breathing rate, and blood flow to the muscles. These internal physiological changes prepare us to fight or run away, and thus stress reaction has been named the “fight or flight” response. The fight or flight response was first described by Harvard physiologist Dr. Walter B. Cannon. It is mediated by the increased release of adrenaline and noradrenalin (epinephrine and norepinephrine) into the blood stream.

References

1. Herbert Benson, Timeless Healing: The Power and Biology of Belief (Fireside: 1997).
2. “Mindful Healing, Technology Review,” Edited by Massachusetts Institute of Technology, October 1996.
3. Jessica Cohen, “The Greatest Story Never Told,” Utne Reader, No. 80, April 1997.
4. “Doctors Report: Faith Can Heal You,” Reader’s Digest, October 1998.
5. Dale A. Matthews, The Faith Factor: Proof of the Healing Power of Prayer, Penguin USA, 1999.
6. L. Miller, et al. “Religiosity and Depression: Ten-year Follow-up of Depressed Mothers and Offspring.” J. Am. Acad. Child Adolescent Psychiatry 1997; 36:10:1416-1425.
7. Ibid.
8. K. S. Kendler, et al. “Religion, Psychopathology, and Substance Use and Abuse: A Multi-measure, Genetic-Epidemiologic Study.” Am. J Psychiatry 1997; 154(3):322-329.
9. “Doctors Report: Faith Can Heal You,” Reader’s Digest, October 1998.
10. “Why Doctors Believe Faith is Powerful Medicine,” Reader’s Digest, October 1999.
11. http://www.nihr.org/media2/99_apr_stress.html

I once asked an Austrian friend of mine who had just qualified as a doctor where he went when he was sick. The surprising answer was that he and most of his colleagues went to a homeopath. He reminded me of our family G. P. who didn’t believe in medicines. I was told ‘just take your son home and make sure he eats well’.

My friend’s preferring a homeopath to one of his fellow professionals, was as I later found out, a rejection of what he had learned during his many years of study. He felt that he had been taught a set of beliefs, which, in his words, ‘did more harm than good’. He believed that he had been trained to ‘manage symptoms using chemicals’ and that his profession had nothing to do with looking for cures or curing people. He told me that he felt dirty when he had finished his shift and that he wasn’t being ‘true to himself’.

My friend may be an exception and is probably frowned upon and dismissed as a crank by other doctors, but, his views raise many interesting issues relevant to professionals and non-professionals alike.

There is an increasing interest in alternative approaches to health. The rise in health shops and alternative clinics show that the world of commerce is cashing in on this fact. Most bookshops stock books on acupuncture, homeopathy and other forms of Eastern medicines. However, the West’s search for an alternative has overlooked the medicine of the Muslim world, sometimes referred to as al Tibb al Nabawi, the medicine of the Prophet or Islamic medicine.

At Tibb al Nabawi

The name al Tibb at Nabawi literally means prophetic medicine. It is based upon the sayings of Muhammad, upon him be peace. However, it encompasses much more than the relatively small number of prophetic sayings. It incorporated Greek and Indian philosophy and practice wherever they were found to be in accordance with the general principles of Islam. The sayings of the Prophet set down general guidelines and principles which later led to the great discoveries and observations of the likes of Ibn Sina and other Muslim thinkers.

This series of articles will be an introduction to some of these principles.

Illness

The word illness, mard, is used in the Qur’an in two different ways. ‘It is no fault in the blind nor in one born lame, nor in one afflicted with illness (mard)’ (Al-Nur, 24.61). This example and the verses like it give special licenses to one who is sick. These licenses include delaying the compulsory fast and not having to fight during wartime. Verses such as ‘and any of you who is ill or has an ailment in his scalp should in compensation either fast or feed the poor’ (Al-Baqara, 2.196) which refer to the sick pilgrim not having to shave or cut his or her hair, led Muslim scholars to attempt to find a legal definition of the word mard illness.

The jurists set out the basis for practical diagnosis. They identified the means by which one could judge illness which included irregularities in the blood, urine, stool, and semen; imbalance in patterns of sleep, eating and drinking and the appearance of wind, sneezing and vomit.

Illness was defined as being ‘out of balance’. This encompassed both physical and mental states. The mental or emotional state is the second usage of the word mard in the Qur’an. ‘In their hearts is a disease (maid)’ (Al-Baqara, 2.15) The heart (qalb), here, refers to ‘the seat of the emotions’, Physically, one is considered to have an illness if one is ‘out of balance’. Likewise, one is emotionally sick if one is out of the natural and pure state that we were created in.

Doctors are needed for some of these emotional and physical illnesses; for others they are not. Tiredness is a symptom of being ‘out of balance’ which can be rectified simply by sleeping.

Islam sees the ultimate curer of these states to be the One who created them. He sent doctors to His creation such as Jesus who cured the leper as well as those suffering from pride and inflated egos. The last of these great doctors was Muhammad, upon him be peace, who, through his advice and practice, set out principles for curing both types of illness.

The state of balance

Common to many systems of alternative medicines is the concept of ‘balance/imbalance’. One’s natural healthy state is a balance between the four qualities of dryness/wetness and hot/cold. The reason a person may have left this state can be either ‘material’ or ‘consequential’. Material sickness is where a substance has entered the body and has caused its balance to shift in one of the several directions. Once the substance is gone the body will return to its natural mizaj, the model of balance.

A ‘consequential’ illness is where the effect of a substance in the body remains after it has left the body. The body is left with an excess of heat/cold or dryness/moisture.

Prophetic medicines sees illness as being caused by either this state of imbalance or damage to an organ or to the natural weakening caused by old age. The doctor’s first job is to discover the cause of illness, consider its cause, think what might encourage it to return it to its correct state act upon that and then depend on the Creator.

SOME BASIC PRINCIPLES

Preparation of medicines

Most medicines in al Tibb al Nabawi are based on the dietary advice of the Messenger, upon him be peace. A simple illness requires a simple medicine. The cure for imbalance leaning towards heat would be something cold. The classic example is the fever. The Prophet said ‘fever is from the hell, put it out with water.’ (Bukhari and Muslim)

A complex illness e.g. one leaning to hot-dry would require a complex mixture, in our example a cold-dry cure.

Every illness has a cure

The Prophet, upon him be peace, said ‘for every illness there is cure. If the cure matches the illness, improvement will take place by the permission of God.’ (related by Jabir in Muslim) and ‘God did not send down an illness except that He sent down a cure (Bukhari).

The above sayings establish there important principles. Firstly, they encourage the administration of medicines. There is agreement among the majority of Muslim scholars that it is a must. Secondly, they imply that, if administering medicine is a compulsion, then searching for a cure must also be a compulsion. Finally, they emphasise the dependence on God. In this modern age of ours we tend to depend on the medicines and not on the True Curer. It is interesting to look at how few remember God in illness until they realise their illness is terminal and that there is no hope for a cure. My own experience is that it is extremely upsetting and often devastating for both patient and doctor when the limitations of modern medicine dawns on them.

Cure may include spiritual as well as physical medicine

Muhammad, upon him be peace, described specific cures which included the likes of honey for the chest and liver. He also described procedures and principles, e.g. ‘emptying the stomach and putting out the fever with water’. In addition, he prescribed prayers and supplications for things like headaches and general sickness. These can be found in the books of hadith, traditions, as well as in the various books of prayers of the Prophet.’

Diet is the key to good health

Himya meaning both precaution and diet. Himya, with both of these meanings is the central pillar of Islamic medicine. The principle is found in the Qur’an which permits the use of sand in place of water in ablution and washing, if the latter is found to be detrimental to health. There was an occasion when the Prophet came with his cousin, Ali, to the house of Um al Mandari bint Qays al Ansari. They began to eat when Muhammad, upon him be peace, stopped and said to Ali ‘you are recovering.’ He took some barley and chard and gave it to him saying ‘this is better for you (related by Ibn Majah)’ The incident is an explanation of the principle of himya in its fullest sense.

Harith, described as the doctor of the Arabs, said ‘himya is the source of every cure, the stomach is the home of every illness.’ The Messenger said: ‘The stomach is the well of the body and the veins drink from it. If it is healthy, the veins pass on good health, if it is sick the veins pass on poison’.

Dietary precaution himya, can be used in three stages.

1. As a cure

2. To keep the body healthy.

3. To aid recovery

Based on the model of Ibn al Qayyim, hakims and traditional doctors have developed a sophisticated system of dietary medicine.

General behaviour and basic hygiene

The Messenger came to perfect behaviour. He taught not only us what foods we should eat hut how they should be prepared. Things like covering food, washing hands before eating and boiling food thoroughly when cooking were all stressed by the Prophet. The same is true of the etiquette of eating. The Messenger taught us to sit in such a manner that our stomach can be filled only to a third of its capacity.

Dieatry advice

The Messenger, upon him he peace, mentioned over seventy specific foods which he considered healthy. Modern science has confirmed that he was right. Among the foods mentioned were honey, dates, vinegar, fish and ginger.

*This article was based on Al Tibb Al Nabawi which is the final section of the book Zad al Ma’d of Ibn al Qayyim al Jawzi. It will be followed by a series of articles expanding on some of the points mentioned above.

References 

1. AL BUKARI (1980) Jami al Sahih
2. AL HAKIM (1965) Majmu’ Zawaid
3. IBN AL QAYYIM (1987) Al Tibb al Nabawi al Taiba
4. MUSLIM (1965) Jami al Sahih