There was a great article I saw from a physician describing his feelings towards prayer being important in his medical practice. He shares two stories about situations in which through praying, there was guidance in advancing the medical help. I was particularly taken by his candidness in acknowledging that his prayer was just a “simple plea for help.” I would offer that prayer is just that. Prayer can be beautiful and poetic. But prayer from the depths, from the heart, is often plain, ugly and brutish. It is the simple musings we feel.
Published Jan 5, 2015
As a physician I am often reminded of two things for which I am grateful. First, the great honor it is to care for people who are in a time of great need in their lives. Second, the many mentors in my life who have patiently taught and trained me in the arts of medicine.
Recently, I have thought a lot about one mentor, the late Dr. Blayne Hirsche. Dr. Hirsche was a gifted plastic and hand surgeon. He trained in surgery at Harvard and the Mayo Clinic. He founded the Hirsche Smiles foundation, which has performed thousands of reconstructive surgeries on children in Mexico and Guatemala. His legacy of compassionate care and service lives on through this foundation.
A Young Surgeon’s Prayer
Before medical school, I had the pleasure of working with Hirsche to gain experience as he performed surgeries. I cannot recall the details of why, but one day we talked about lessons he had learned during his training. One story he told has stuck with me ever since. He talked about a difficult surgery he was performing as a resident physician at Harvard. The head surgeon was world-renowned for the procedure being performed. Unfortunately, severe abdominal bleeding complicated the surgery.
At one point, it became apparent to Hirsche that the patient was going to bleed to death. Blood would rapidly fill the open abdomen as quickly as the surgical team could evacuate it, making it impossible for them to find the bleeding source. Suddenly the room became quiet and all eyes were directed toward the lead surgeon, who had stopped talking and working. A few moments later the surgeon reached into the abdomen and the bleeding stopped. His fingers had found the bleeding source, and with pressure the bleeding stopped. With the bleeding source identified, the surgeons quickly sutured the area, and the patient lived.
After the surgery, Hirsche asked the lead surgeon what had happened and why had he stopped. The lead surgeon said he stopped when he realized they were going to lose the patient, and he prayed for help. The surgeon did not say anything more. This was a profound experience for Hirsche as this surgeon was not known as a spiritual person. In fact, this was the one and only spiritual statement this surgeon ever made to Hirsche.
A Young Mother’s Difficult Heart Procedure
Most physicians are very aware of the limitations of medicine and medical procedures. Despite our best intentions, we often lose the battle to diseases. Every patient is unique, and even routine procedures can be challenging. All physicians who treat life-threatening diseases and have been in situations where they know they’re doing all they can for a patient and yet the patient’s life is slowly slipping away.
Hirsche shared his story with me nearly 20 years ago. His message found its way into my practice recently. A young mother of four children came to the hospital in severe heart failure. Four weeks earlier she had delivered a healthy baby. Now her heart was failing as 90 percent of the pumping function was no longer working.
As her heart failed, her lower heart chambers dilated and stretched, causing abnormally fast heart rhythms to develop. This further worsened her heart failure. Strong intravenous medications were started to support her blood pressure and fight impending kidney and respiratory failure. Despite our strongest intravenous medications to make the heart beat normally, as well as multiple electrical shocks to her heart, her abnormal heart rhythms continued.
It was clear she was close to dying, but we had a few options. One was to replace the heart with an artificial heart until she could get a heart transplant. Another option was to do open heart surgery to place heart pumps, called ventricular assist devices, to support her failing heart. The third was to go into her heart through her blood vessels, find the source of the abnormal heart rhythm, and destroy it. This could allow the heart to slow down and hopefully recover. Due to potential challenges with placing a heart pump, the third option was felt to be the best. For that reason, I became involved.
A Simple Plea for Help
When she arrived in our cardiac catheterization room, she was placed on a breathing machine. The room buzzed with physicians specializing in high-risk anesthesia, critical-care medicine, heart failure, and surgery. The cardiac surgery team was on standby to perform an emergency procedure, if needed, to transition her to a transplant. As we prepared for the cath procedure, her blood pressure continued to fall, requiring more medications to support it. Her blood oxygen level also started to fall, despite respiratory support. I quickly gained access to her blood vessels. In the setting of severe heart failure, these ablation procedures to treat abnormal heart rhythms often take four to six hours. I knew she didn’t have that much time.
Before I advanced the tool into her heart, I prayed silently. My prayers are not graceful and eloquent. I would characterize them as a simple plea for help. A few seconds after my prayer, I advanced a tool into her heart to the area I thought was most likely causing the abnormal rhythm. As the tool touched this area, the abnormal heart rhythm stopped. We delivered heat energy to the site to destroy the short circuit. Her blood pressure and blood oxygen began to rise. And her heart rate — once at 150 to 160 beats per minute — now beat normally at 100 beats per minute.
I have treated hundreds of these abnormal heart rhythms, but I have never seen such a quick response. Within five minutes of starting the procedure, her heart was normal. That night I was able to talk with her. She held my hand and said “Thank you.” There was not a lot more to say. It was humbling for me because I realized that a few hours earlier we both had pleaded for help. I am happy to report she is on her way to recovery. Her heart is getting stronger each day.
Faith and Hope Among Physicians
I have had many mentors who draw great strength from spiritual sources. Some have been Christians like me, while others were Jewish, Hindus, Buddhists, and Muslims. That is one of the great aspects of medicine: A tremendous diversity of backgrounds come together for a common goal. I have heard some people say that physician spirituality is a sign of weakness, but I have found the opposite to be true. These mentors of mine are world leaders in their fields and draw from all means to treat and care for people in a field that does not have all the answers. They use their faith to find inner strength and peace. To a believer of spiritual things these stories can make believing easier.
It is harder when prayers and best intentions fail. Believers will often say that when this occurs it is part of a greater plan or design. To a nonbeliever of spiritual things, perceived failures make it easier not to believe.
I am grateful for my patients who have told me that they, their family, or pastor have prayed for me and they believe everything will be all right. These gestures are filled with great faith and hope. Hope and optimism, regardless of belief, are associated with better outcomes and longevity. I once had a Catholic patient who came in for a very small routine procedure. He also took my hand and said, “It will be alright, I had my last rites read to me.” I am not sure if that was a vote of confidence. I told him thank you, but I was not planning on letting him die just yet.
I have a close friend who is an atheist. He told me one day, “You know all of this is not going to matter in the end, as we all die and aren’t coming back.”
I told him that is what makes it even more meaningful. Because when we do die, it is important to have hope in a better tomorrow.