By Tracy Balboni

In 2006, the same year I was completing my training in radiation oncology and embarking on a career of caring for patients with incurable cancers, I first read this quote from Dr.DanielSulmasy in The Rebirth of the Clinic: An Introduction to Spirituality in Health Care:

“Illness is a spiritual event.  It grasps persons by the soul as well as by the body and disturbs both. Illness ineluctably raises troubling questions of a transcendent nature-questions about meaning, value, and relationship. These questions are spiritual.”

At that particular time in 2006, Sulmasy’s words contrasted starkly with my experience as a trainee in scientific medicine. Medicine was largely blind to the reality that illness is a “spiritual event”. And yet, I knew viscerally in my nascent experience as a physician that Sulmasy’s words were correct.  In the clash between my training and the truth expressed so poignantly by Sulmasy, I discerned a calling to translate this reality into words that medicine could hear and understand — the language of empirical research.

And so I embarked upon an academic career dedicated to translating the spiritual realities of patients into the language of numbers and the format of scientific manuscripts. I also had my own questions to pose and answer. Do patients want for their physicians and other members of the medical team to recognize and attend to the spiritual aspects of their illness experience? If we do embrace the spiritual aspects of illness, how does this influence patients’ well-being and medical care decisions?

With the above questions in mind, I embarked on research within the Coping with Cancer studyunder the mentorship of Holly Prigerson, PhD, the study’s principal investigator, whose vision and creativity have been transformative to the understanding of psychosocial and spiritual factors in end-of-life care. The study involved interviews and observations of 343 patients with advanced, incurable cancers and their family caregivers.

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By Michael J. Balboni

This is the second entry in a four-part series examining the social and historical forces that have led to the current divide between religion and medicine. Drawing on Peter Berger’s theory of plausibility structures (particular social processes that legitimize social beliefs and practices, giving them a matter-of-fact quality), this series examines key factors that lie behind the current state of spirituality in medicine. This post focuses on our cultural beliefs about physicians as scientists, and how the late nineteenth century alliance with science has transforming the meaning of the medical vocation.

Throughout the history of Western medicine, physicians viewed themselves as invested with a divine mission and purpose. In fact, according to sociologist Jonathan Imber, the initial ascendance of the medical profession during the middle of the Nineteenth century was due in part to the fact that physicians were allied with and morally commissioned by Protestant clergy. Imber suggests that Protestant clergy empowered the medical profession with a moral and spiritual vocation, resulting in a deeply held public trust of physicians.[1] A vivid depiction of this spiritual/medical vocation can be seen in Luke Fildes’ 1891 painting, The Doctor. In this painting, the physician leans pensively over the sickbed of an ill child. The tools of his trade are pushed to the side, as illness takes the upper hand, whereas a light shines on his thoughtful face and gentle expression. He is here not only to offer his medical skills, but also to shepherd the family through a difficult and painful experience. (more…)

By Michael Balboni

This is the first in a four-part series examining the social and historical forces that have led to the current divide between religion and medicine. Drawing on Peter Berger’s theory of plausibility structures (particular social processes that legitimize social beliefs and practices, giving them a matter-of-fact quality), this series will examine the driving factors behind the current state of spirituality in medicine. This post centers on the evolution of the hospital from the medieval period to the modern day, and how religion came to be of lessened importance in this setting.

Many modern American hospitals (especially in wealthy areas) are palatial and imposing, home to a wide variety of medical specialists and technologies. It can be intimidating to step into the imposing marble entryway of Dana-Farber’s Yawkey building or the labyrinth of Brigham and Women’s Hospital, the hospitals where I work, especially when one is facing a potentially devastating diagnosis. Patients of faith may also notice that for all their technological marvels, modern hospitals offer little by way of spiritual support to help them navigate their experience of illness.

This wasn’t always the case. During the medieval period, hospitals were primarily affiliated with religious organizations, who sought to ensure the comfort of patients and support them as they entered into right relationship with God in their last days of life.
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