More Difficult Questions

“Doctor, do you believe in God?”

This question comes up more often than I had expected when entering medical training.  I was immersing myself in the world of science.  I anticipated questions from patients and family members about diagnosis, prognosis, or treatment options.  My studies prepared me to address these inquiries.  But science is not the only worldview on patients’ minds.

In general, I plan to avoid discussing religion and politics, since these tend to be divisive topics.  However, both are inextricably linked to the practice of medicine and cannot be ignored.  And I’m sure I am not the only one who has been asked this question in a patient care situation, so it is worth wrestling with it here.  I cannot claim to have a good answer for dealing with this, but I can offer my experience.

The most recent instance was a patient who was struggling with losing his job, in the context of depression, anxiety, and a history of alcohol and drug dependence.  Suddenly, his security, future plans, identity, relationships were all disrupted.  I have also been asked this question by a woman undergoing ovarian cancer treatment, the mother of a comatose patient in the intensive care unit, a man in recovery from a debilitating stroke, and a man dying slowly of congestive heart failure.

I could decline to answer.  There are plenty of questions that I consider outside the scope of our doctor-patient relationship and redirect the conversation away from them (such as questions about whom I plan to vote for).  But questions of faith are, in fact, relevant. 

I want to know my patients’ values and beliefs.  They are important not only in life-and-death decisions but in any condition that could be affected by social support or coping skills.  If it seems helpful to my patients to know my values and beliefs and they directly ask me, I will share.

I usually do not know the agenda behind the question at the time.  My patient and I may have very different backgrounds and perspectives.  The important thing is not that we have the same belief but that we seek to understand each other.  So, I answer honestly.  And I open up the conversation and make it okay for my patients to talk about the spiritual side of their health and illness.

Happy Easter to everyone celebrating, this week and last week.