One Doctor's Spiritual Journey (So Far)

Health Progress, May/Jun 2006 by Phelps, Gregory

HEALTH CARE NEEDS SPIRITUALITY

After three and a half years, my time at Aquinas is winding down. I will be graduating in May.

Meanwhile, I see evidence of institutional spirituality everywhere at St. Mary's. Our management team engages in spiritual reflection by writing and discussing reviews of books on spirituality. A few of us carry this a little further, combining the book discussion with a monthly lunch; we call our group the "Dead Theologians' Society." Coming to work at St. Mary's has been, at least in part, an exercise in spirituality. It is part of what I have been learning: to live each day sacramentally. My care for my patients has become not just my job or profession, but my ministry.

But how do I carry this information outward?

I can help educate administrators, colleagues, and patients on the benefits of bringing spirituality to the fore in health care. Health care is widely acknowledged to be approaching a crisis point. For years, we have heard talk about bringing the "business model" and its efficiencies into health care. Recent lawsuits have highlighted the issues of billing the uninsured. Recent federal and state cuts to Medicaid and Medicare leave our most vulnerable citizens in a state of declining health.

In 1992, the University of Chicago's Gary Becker won the Nobel Prize in economics for documenting what most of us had already intuited-that people are likely to choose careers in higher-paid fields than in lower-paid ones. When, therefore, health care is based solely on a business model, its ministry aspects will tend to be shunted to the side. The same is true for physician economics. If the business model is the only one available, that model will rule.

So, unsurprisingly, the U.S. health care system, shorn of its mission and ministry aspects, is evolving in a business direction. A similar shift is occurring on the individual level as prospective physicians plot their career paths on the basis of personal satisfaction rather than community need. Medical students clamor to enter specialties that are highly technical; pay well; and, because they can be performed during regular hours, make little demand on the physician's personal time. This has become so pronounced that, last winter, the American College of Physicians announced that primary care-which, although basic, offers few to none of the above attractions-is in crisis.2 Most medical students enter school as idealists. But because they are not encouraged to attend to medicine's aspects of spirituality, mission, and ministry, they often become cynics.

Spiritual care applies to patients as well. In his book The Holy Longing: The Search for a Christian Spirituality, Ronald Rolheiser discusses how much of our detrimental lifestyle choices are really efforts to try to fill the hole left by a failure to address our spiritual needs.3 Public health experts estimate that upwards of 50 percent of premature morbidity and mortality is related to lifestyle.4

These lifestyle choices include drug and alcohol addiction, smoking, failure to exercise, stress, unbalanced lives, and obesity. Recently, I had a first- hand opportunity to see this up close when I filled in for our rural hospitalist at St. Mary's Jefferson Memorial Hospital, Jefferson City, TN. Two of the eight patients I saw were in our intensive care unit as a result of drug overdoses. Another, who was in police custody, had been found positive for hepatitis C. While these three people had been brought to the hospital with "medical issues," it was clear that each of them suffered from an underlying spiritual malaise.