Wednesday, May 18, 2011

Oh no, I said too much.

"Every whisper. . .
Of every waking hour I'm
Choosing my confessions
Trying to keep an eye on you
Like a hurt lost and blinded fool, fool

Oh no, I've said too much. . ."

~ from R.E.M. "Losing My Religion"

Sometimes patients ask you things that catch you off guard. Things like, "Hey, what race are you?" or even funny ones like, "When's the baby comin'?" when you aren't even pregnant. And sure. Those questions can be both perplexing and amusing at times -- which reminds me-- why is it that only black folks ask (black) me "what are you?" or even why is it that the very day you feel your most sleek and trim post-pregnancy just happens to be the day that some patient winks at you in the elevator and says, "Is it a boy?"

Um, yeah.

But those questions? Those questions are easy. Here's a question that can be a hard one:

"Do you believe in God?"

Or more specifically if you work at a place like Grady Hospital:

"Do you believe in Jesus?"
Now here's the thing: even for folks that have a very clear answer in their head to that question, it isn't necessarily an easy one. It steps into a fuzzy place that sometimes doctors get squirmy in with their patients. That personal space place. That inner thoughts and feelings place. And for some, that flat out none-of-your-business place.


Today I'm reflecting on this because yesterday I was leading a session with my second year small group students and the topic was "Spirituality and Medicine." Our discussion started off simple enough and then evolved to this one where we got into a very interesting dialogue about how one responds to patients asking questions about your religious beliefs (or lack thereof.)

The students had some interesting perspectives. They represent many different beliefs on a myriad of intensities, so I was keen on hearing their thoughts. One person asked if the best thing to do was to "just tell the person what they want to hear." Another was firmly against that. Some offered thoughtful examples of how they could navigate respecting where the patient was and protecting their own privacy. A few weren't sure what they'd do. And eventually, they asked me what I thought.

members of "Small Group Beta"

Okay. So, I think I am fairly transparent on this blog, or at least I try to be. Most have probably gathered that I am of Christian faith and wouldn't be surprised when I describe myself as observant. Nope, I'm not fire and brimstone. Nope, I don't have flaming stones to sling from my purse or hateful, disgusted stares for boys who hold hands with boys. Nope. I generally stay in my lane when it comes to judging since the whole judging thing is not my lane. I tend to focus more on that whole "love everybody" thing that Jesus was so into.


I don't pretend to be anyone other than who I just described and have what I like to refer to as a "personal relationship" with God. I pray regularly. Some days more than others. And fortunately, since my relationship with God is personal and we know each other so well, my guess is that He's cool with that. Some people fall into this "personal relationship" category, too, but their relationship with a higher power is so personal that chatting them up about it is like asking them about their weight. A major no no.

Though that isn't usually where I am, I do sometimes wince a teeny bit when the topic comes up. Sometimes it's because I am accompanied by someone else. Other times it's because I fear it will take me somewhere I am not sure I want to go with a patient. So, to answer their question, I tell them something that I heard a resident once say on rounds when asked those very questions:

"May I ask a question of you? Can you tell me why it is that you'd be interested in knowing that about me?"

It was one of the most kind replies to such a question that I'd ever heard. This came out of the mouth of a second year resident, too. He softened his eyes and his voice and respectfully countered with this beautiful response. And I meant to say "beautiful" because it was just that.

This resident happened to not be of Christian faith at all. But the answer the patient gave was so endearing. She simply said, "I want to know because I really like you. I want to know that your soul is saved, so that I can be praying for you if it's not."

And he replied, "I always appreciate prayers."

And she simply smiled back and nodded.
I have used a version of this ever since. One patient answered me by saying, "I want to make sure that the doctors caring for me are believers and that they don't think they God!"

I was with my entire ward team that day, and through this insight was able to answer accordingly.

"Ma'am, to be honest, I am of Christian faith. But more important, I certainly do not think that I am God. I also work with a number of wonderful doctors and students--some of whom are of Christian faith and some of whom are not--and I feel sure that they don't think of themselves as God or all powerful either. We just try our best to do right by you and give you our very best effort. That's something you should want all of your doctors to have in common."

And that answer feels good to me because it doesn't exclude or disrespect the scores of colleagues I have that have different beliefs than my own. Particularly when they are present when I'm asked.
Now. I'd be dishonest if I told you that there hadn't been many a time that I'd joined a patient in prayer or agreed to pray for them. In fact, I've closed my eyes and prayed for a patient right then and there at their bedside before. This has depended upon a lot of factors. The relationship I had with the patient, the urgency of the situation, and of course, the wishes of the patient. Other times, those prayers have been uttered quietly at chart boxes or in stairwells. . . oft times the nearest place I can privately reach to interlace my own beliefs with what I can do medically.

I am not sure these answers are the right answers. In fact, somebody reading this is probably saying that they aren't even close to the right answers. I don't know. But here's what I do know: Medicine is about a whole lot more than medicine. And regardless of what you believe or don't believe. . .it involves having some faith. Sometimes in you. Sometimes in your doctors. And sometimes, if that's your thing, in something altogether different.
Anyways. That's all I've got today. Happy Wednesday.

Now playing on my mental iPod. . . . .

Losing my religion by REM


  1. I wandered over here from a PA student blog, and I am SO glad I did! As an ex-CNA, I was asked questions about my faith all the time. I'm not sure whether it was due to the intimate nature of the job or the fact that many of my patients had literally brushed by death, but there you go.

    I stumbled on my answer every time, as I'm an atheist. I've found that people who are religious often find it difficult to understand my own peace and happiness with my lack of faith, and it always felt inappropriate to go down that "negative" (in their mind) conversational route. Why make them fret over why I don't believe or feel burdened that they must now pray for me when they have their own sickness to battle?

    So, I would attempt to bring the focus back on them and their own beliefs. I was never as graceful as that resident you spoke of, and I hope I can remember his words next time I encounter this as a student or PA. It really is a thing of beauty. :) Regardless of where we come from, we all have the same goals in medicine after all...

  2. You give me so much to think about!

  3. azkitty- Claro que si! We so have the same goal! :)

    Rachael - That's a great compliment to hear! By the way--you give me so much to smile about on your blog! :)

  4. You know, darling, this is one of my favorite songs in the world and when I saw the original video on MTV back so many years ago, I thought to myself, "Okay, this is why the music video was invented."
    Isn't it amazing how music and words can come from such different places and answer so many questions of such different origins?
    Thank-you. You've reminded me of this song and I think I'm going to post it myself.
    Bless you, darling, for the all the good work you do, both scientifically and spiritually and artistically.
    I mean it.

  5. Some songs, when remembered, remind us of who we were, how we were, who we've become, who we've always been. Thank you for reminding me --

    Such an exceptional post.

  6. I loved reading this.
    Really interesting, important stuff.
    Thank you.

  7. Hi Dr. Manning, I'm actually a Chaplain at Grady and recently came across your blog. I so admire the honesty, integrity, and transparency you bring to your work. In fact, several of your blog posts have caused quite the conversation around our office... as Chaplains we always hope Doctors are engaging the spiritual elements of patient care- but we sometimes don't get to hear it straight from the Doctor's mouth! :)
    All that to say, I think your answer to this question (which, by the way, Chaplains often struggle with as well) is a beautiful one- it honors that sacred place of trust you hold with a patient while also not allowing it to become all about you. Which, is always easier said than done! So glad to know you are passing this lesson on to so many future doctors and treating our Grady pts with so much love and respect. Thank you, thank you for the work you do.

  8. Gradydoctor, I've been lurking around for a while, laughed out loud at your hair salon post, and today, I am delurking to say what a beautiful spirit you have. I love this post. So personal and respectful of all beliefs, so caring towards your patients and students, so deeply humane. Thank you for this kind and thoughtful and nonjudging mediation on the ways in which we believe. There's a reason I keep coming back here.

  9. Ms. Moon & Elizabeth - there's something so haunting about that song, isn't it? Love it, too. And thanks for the kind words.

    Bethany - so glad you stopped by and reflected, too.

    Stonese- hand on my chest, shaking my head. Wow. Thanks for all you do.

    Angella - There's over a billion blogs. So appreciate you coming back to this one. For real.

  10. Great post. I'm not religious at all, spiritual but not religious.

    Thanks for posting this. I'd forgotten how much I love Michael Stipe and what a brilliant song this is xx

  11. My first time here, Missy...and I will be back. Thank you for the music and a delightfully thought provoking post...

  12. It's refreshing to hear another doctor reflect on this question. I feel like we're trained to avoid these topics and yet spirituality is such a key component to who a person is. Thanks for writing this!

  13. I really loved this. Thanks for sharing this story. Definitely noted for when I encounter similar situations in the future.

    Derin A.


"Tell me something good. . . tell me that you like it, yeah." ~ Chaka Khan

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